Dialysis vascular access continues to be both a 'lifeline' and an 'Achilles' heel' for patients on haemodialysis. In this Review, the authors address some of the problems associated with vascular access, including dialysis access stenosis and arteriovenous fistula (AVF) maturation failure. They discuss the role of monitoring and surveillance, describe process of care pathways intended to increase AVF rates and decrease catheter use, and discuss novel therapies designed to reduce vascular access dysfunction.
- Miguel C. Riella
- Prabir Roy-Chaudhury