A: Artcriovenous fistulas have superior longevity compared to synthetic grafts. 85% versus 50% at two years. Longevity is the key. Excluding a successful transplant these patients will require dialysis for the rest of their lives. And access sites are limited. Infection and central vein thrombosis preclude a policy of long-term maintenance dialysis through tunneled central vein catheters. B: Following the creation of a fistula it usually requires three or four months if it happens at all for the egress vein to enlarge sufficiently for efficient dialysis. This compares to a perhaps two week period after a synthetic graft is bridged between the brachial artery and vein. A straight or tunneled dialysis catheter can be used immediately. C: Unlike the fistula a patient doesnt have to get stuck three days a week with a temporary central vein catheter. D: A temporary dialysis catheter can be quickly placed and at the bedside if necessary.
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