title: Hemodialysis vascular access: everything you always wanted to know about it (but were afraid to ask).
abstract: Vascular accesses are essential for effective dialysis treatment. Arteriovenous fistulas, grafts and central venous catheters are the options available to the nephrologist, but they all have their pros and cons. All of the 3 types of vascular access share the same complications but at different rates, and their costs vary enormously, with on balance the arteriovenous fistula being the best choice. Nevertheless, recently the number of incident patients starting dialysis treatment with a venous catheter as vascular access has been steadily increasing. This is true even for more advanced countries such as the United States, where despite the efforts made to promote the use of fistulas, their prevalence is still low compared with Europe. Moreover, nowadays nephrologists are required to master technical skills that once were those of surgeons and to perform interventions to preserve the patency of the access. The aim of this paper is to review the prevalence, benefits and complications of the different vascular accesses in light of the most recent findings.
authors.affiliation: Unit of Nephrology and Hemodialysis, Salvatore Maugeri Foundation IRCCS, University of Pavia, Pavia - Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Torreggiani
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Scaramuzzi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manini
authors.forename: Francesca
authors.initials: F
authors.lastname: Castoldi
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Serpieri
authors.forename: Noemi
authors.initials: N
authors.lastname: Maggi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sileno
authors.forename: Clara
authors.initials: C
authors.lastname: Migotto
authors.forename: Vittoria
authors.initials: V
authors.lastname: Esposito
authors.forename: Francesca
authors.initials: F
authors.lastname: Montagna
authors.forename: Ciro
authors.initials: C
authors.lastname: Esposito
mesh_terms: D000367:Age Factors; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005060:Europe; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D009398:Nephrology; D010819:Physician's Role; D006435:Renal Dialysis / Q000379:methods*