Vascular access for dialysis
Fistula, graft or catheter and how to choose under the KDOQI 2019 ESKD Life-Plan, when to refer for access surgery, vein preservation, pre-operative mapping, examining a fistula and judging maturity, catheter placement rules, and the problems that need same-day referral.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Three options: arteriovenous fistula (AVF), arteriovenous graft (AVG) and tunnelled central venous catheter (CVC).
- A fistula has the best long-term patency and the lowest infection risk but needs weeks to months to mature, and some never do.
- KDOQI 2019 replaced "fistula first" with the individual ESKD Life-Plan. The current KHA-CARI access guideline is from 2012.
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Sources
- KHA-CARI Guidelines, Dialysis (vascular access 2012; infection control for haemodialysis units 2018)AU/NZKidney Health Australia - Caring for Australians and New Zealanders with Kidney Impairment, 2012 (still the current KHA-CARI access guideline, checked November 2026)
- Lok CE et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis 2020;75(4 Suppl 2):S1-S164National Kidney Foundation, 2019 update (published 2020)
- Schmidli J et al. Vascular access: 2018 clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018;55:757-818European Society for Vascular Surgery, 2018
- Chronic Kidney Disease (CKD) Management in Primary Care, 5th editionAU/NZKidney Health Australia, 2024
- ANZDATA Registry Annual Reports (haemodialysis vascular access chapters)AU/NZAustralia and New Zealand Dialysis and Transplant Registry
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback