[Placement of a native arteriovenous access]

The epidemically increasing number of diabetics is resulting in an increasing number of patients with end-stage renal failure who, furthermore, show a high degree of co-morbidity. An increasingly longer survival time with dialysis also means that the group of patients requiring functional dialysis access is continuously growing. The autologous arteriovenous fistula with its high function and low complication rate is the best access form, and should be provided to as many of those patients requiring dialysis as possible. This article discusses the timing of dialysis access, the importance of the medical history and the physical examination, preoperative investigation of the prospective fistula vein, the possibilities of anastomosis, maturation of the fistula and long-term results.