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Related Experiment Video

Updated: May 6, 2026

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Vascular access today.

Konstantinos Pantelias1, Eirini Grapsa

  • 1Konstantinos Pantelias, Eirin Grapsa, Nephrology Department, Aretaieio University Hospital, University of Athens, 11528 Athens, Greece.

World Journal of Nephrology
|November 1, 2013
PubMed
Summary

Vascular access (VA) is crucial for hemodialysis (HD) patients. Native arteriovenous fistulas (AVFs) offer the best long-term outcomes, despite ongoing complications with all VA types.

Keywords:
Arteriovenous fistulaArteriovenous graftCentral venous catheterCuffed central venous catheterHemodialysisVascular access

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Medical Devices

Background:

  • Chronic kidney disease (CKD) prevalence is rising globally, increasing the need for renal replacement therapy.
  • Hemodialysis (HD) is the most common renal replacement therapy, relying heavily on effective vascular access (VA).
  • Despite advancements in HD, vascular access methods have seen limited innovation.

Purpose of the Study:

  • To review the current state of vascular access for hemodialysis.
  • To highlight the common complications and challenges associated with different VA types.
  • To emphasize the enduring importance of native arteriovenous fistulas.

Main Methods:

  • Literature review of vascular access options for hemodialysis.
  • Analysis of complication rates, survival, and intervention needs for various VA types.
  • Comparison of native arteriovenous fistulas, grafts, and catheters.

Main Results:

  • Common VA types include arteriovenous fistulas (AVFs), polytetrafluoroethylene grafts, and cuffed central venous catheters.
  • Thrombosis, bleeding, and infection are prevalent complications across all VA types, leading to significant morbidity.
  • Native forearm AVFs demonstrate the longest survival and require the fewest interventions, making them the preferred choice.

Conclusions:

  • Vascular access remains a critical challenge for hemodialysis patients.
  • Native AVFs, particularly forearm AVFs, are the optimal choice for vascular access due to superior longevity and lower complication rates.
  • Further improvements are needed to address the persistent problems and complications associated with hemodialysis vascular access.