Vascular access for hemodialysis: A perpetual challenge

Abstract

Vascular access for hemodialysis has a long and rich history. This article highlights major innovations and milestones in the history of angioaccess for hemodialysis. Advances in achievement of lasting hemodialysis access, swift access transition, immediate and sustaining access to vascular space built the momentum at different turning points of access history and shaped the current practice of vascular access strategy. In the present era, absent of large-scale clinical trials to validate practice, the ever-changing demographic and comorbidity makeup of the dialysis population pushes against stereotypical angioaccess goals. The future of hemodialysis vascular access would benefit from proper randomized clinical trials and acclimatization to clinical contexts.

Keywords: arteriovenous access; central venous catheter; fistula; graft; hemodialysis.

© 2019 Wiley Periodicals, Inc.

Figures

FIGURE 1

History of hemodialysis vascular access

FIGURE 2

Trends in the practice of hemodialysis vascular access