A Three-Step Approach to Conversion of Prevalent Catheter-Dependent Hemodialysis Patients to Arteriovenous Access‪.‬

Introduction The arteriovenous fistula (AVF) is universally accepted as the optimal vascular access for chronic HD patients (Mendelssohn et al., 2006b). The second best is the arteriovenous graft (AVG), while the least desirable is the central venous catheter (CVC) (Astor et al., 2005; Hemodialysis Clinical Practice Guidelines for the Canadian Society of Nephrology, 2006; NKF-KDOQI, 2006; Polkinghorne, McDonald, Atkins, & Kerr, 2004). The AVF is associated with decreased mortality and morbidity, low complication and procedure rates, and improved longterm survival when compared to an AVG and CVC (Astor et al., 2005; Dhingra, Young, Hulbert-Shearon, Leavey, & Port, 2001; Lok, 2007, NKF-KDOQI, 2006; Pastan, Soucie, & McClellan, 2002; Pisoni et al., 2002; Polkinghorne et al., 2004; Xue, Dahl, Ebben, & Collins, 2003).