Hi group,
If you had to start hemodialysis what vascular access would you choose? AVF, AVG, Catheter? and Why?

I don't think there is a best one for all patients. I think you would have to prioritize these considerations:

1. Body image change and/or disfigurement

2. Maintenance required

3. Access life span expectancy

4. Blood flow rate capability

5. Incidence of infection

6. Time span until dialysis initiation

7. Tolerance for pain

Are there others?

In reality, how many choices are patients typically given?

I would choose an upper arm AVF. It has been my experience, the upper arm AVFs I have worked with have fewer clotting episodes with increase longevity. However, if I were placing my own needles, I would prefer a upper leg bovine graft. Are bovine grafts still used any place? Any way I saw very few clotting problems with bovine grafts. I think attempting to place my own needles in my leg would be easier than in my arm.