[With the right shut. Well prepared for dialysis]

To accomplish hemodialysis in the patient requiring regular dialysis, a well-made shunt establishing a permanent access to the vascular system is essential. This involves making a connection between a vein and an artery, either directly or via a plastic prosthesis. A classic example is the Cimino shunt, a subcutaneous shunt between the cephalic vein and the radial artery, which today can usually be carried out under plexus anesthesia. It is important to establish the indication for a shunt in good time and to optimally prepare the patient, e.g. by vein training. In cooperation with the nephrologist, the vascular status of the patient, and prior diseases such as peripheral occlusive arterial disease or diabetes mellitus, must be established. A fully functional shunt is essential for the patient with terminal kidney failure to be able to lead a civilized life of the long-term.