title: New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?
abstract: Optimal vascular access planning begins when the patient is in the predialysis stages of CKD. The choice of optimal vascular access for an individual patient and determining timing of access creation are dependent on a multitude of factors that can vary widely with each patient, including demographics, comorbidities, anatomy, and personal preferences. It is important to consider every patient's ESRD life plan (hence, their overall dialysis access life plan for every vascular access creation or placement). Optimal access type and timing of access creation are also influenced by factors external to the patient, such as surgeon experience and processes of care. In this review, we will discuss the key determinants in optimal access type and timing of access creation for upper extremity arteriovenous fistulas and grafts.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; and.
authors.forename: Karen
authors.initials: K
authors.lastname: Woo
authors.affiliation: Division of Nephrology, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Charmaine E
authors.initials: CE
authors.lastname: Lok
mesh_terms: D000367:Age Factors; D001158:Arteries / Q000033:anatomy & histology; D001166:Arteriovenous Shunt, Surgical; D002983:Clinical Competence; D015897:Comorbidity; D005006:Ethnicity; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010347:Patient Care Planning; D057240:Patient Preference; D006435:Renal Dialysis; D012737:Sex Factors; D013997:Time Factors; D058017:Vascular Grafting; D014680:Veins / Q000033:anatomy & histology
keywords: Arteriovenous Shunt; Fluid Therapy; Humans; Surgical; arteriovenous fistula; arteriovenous graft; hemodialysis access; renal dialysis; timing of creation