title: We Refuse to Give up on Nonmaturing Fistulas.
abstract: The nonmaturing arteriovenous fistula (AVF) is a major problem and can lead to significant patient morbidity and mortality because the patient is exposed to the risk of dialysis with a central venous catheter (CVC). Access planning should include a strategy to decrease the incidence of AVF nonmaturation. All newly created AVFs should be evaluated for maturation at 4-6 weeks. If it is judged to not be usable at that time, it should be evaluated for salvage. However, if multiple procedures over a prolonged period of time are necessary for salvage, the decreasing chances of long-term success with the increasing risks of CVC-based dialysis must be considered. Giving up on the nonmaturing AVF may be in the best interest of the patient.
authors.affiliation: Lifeline Vascular Access and the University of Texas Medical Branch, Houston, Texas.
authors.forename: Gerald A
authors.initials: GA
authors.lastname: Beathard
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D062905:Central Venous Catheters; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000628:therapy*; D009398:Nephrology / Q000379:methods*; D006435:Renal Dialysis; D016879:Salvage Therapy