My understanding is that if I need to get dialysis the Nephrologist makes a decision on what type of access to give me.
1. avf+temp cath
2. graft+temp cath
3. perm cath

what is the current % for each I am hearing that about 20% are avf, 65% are grafts and 15% are perm caths, is this accurate?

Also I have been reading that avf are getting a big push here is the US, what incentives are in place to help increase this percentage? And do you think in 3-4 years we can get up to 50% avf.

Thanks and happy Presidents' day
curious

Dear Curious,
I don't know where you got your information regarding the percentages of vascular access types, but you are right on the money! Since your access will be your "lifeline", this decision should be made after a careful discussion with your Nephrologist or Vascular Surgeon. It is a well known fact that dialysis patients overall require 1 access related intervention annually. It is also a well known fact that AV Fistulas have the longest survival rate. More AV Grafts are done in this country because a significant number of patients starting dialysis have Diabetes or severe Hypertension both of which can cause vessel disease which may preclude the creation of a native AV Fistula. A perma Cath is not the best choice unless your disease prevents the creation of an access in one of your limbs. My personal choice would be: 1: AV Fistula, 2:AV Graft, 3: Perma. Cath. You may need to have a temporary catheter inserted while your fistula matures. Many types of grafts can be used immediately. I hope this helps you and I wish you the best.

Curious,

The answer you just got is right on! An A-V Fistula is the gold standard. Please contact the National Kidney Foundation @ 1-800-622-9010 and ask for a copy of the DOQI (Dialysis Outcomes Quality Initative) patient booklet on the DOQI Vascular Access Guidelines and a copy of the Family Focus Newsletter DOQI issue. They will mail out free copies to you. The NKF is on-line at www.kidney.org and the full DOQI Guidlines for Vascular Access and the other topics are all on the web site. Please post any additional questions you have about vascular access.

Best wishes to you as you start dialysis.

Deborah

[This message has been edited by Deborah Brouwer (edited 07-27-2000).]