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Nephrology Dialysis Transplantation 2005 20(4):688-690; doi:10.1093/ndt/gfh730
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Personal Opinion

Timing of first cannulation of arteriovenous fistula: are we waiting too long?

Rajiv Saran1,2,4, Ronald L. Pisoni3 and Eric W. Young1

1 Division of Nephrology, 2 Kidney Epidemiology and Cost Center and 3 University Renal Research and Education Association, University of Michigan and 4 Veteran Affairs Medical Center, Ann Arbor, MI, USA

Correspondence and offprint requests to: Rajiv Saran, MD, MS, Kidney Epidemiology and Cost Center, University of Michigan, 315 W. Huron, Suite 240, Ann Arbor, MI 48103, USA. Email: rsaran@umich.edu

Keywords: arteriovenous fistula; DOPPS; first cannulation; haemodialysis

The first 10% of the full text of this article appears below.



   Introduction
 
Timing of first cannulation of an arteriovenous (AV) fistula remains a controversial subject, but has been the subject of a few investigations reported in the literature recently [1–4]. The current K/DOQI practice guidelines pertaining to this topic [5] are based on opinion and need to be re-evaluated in the light of these recently published studies. These guidelines state that one should wait for ≥1 month, but preferably 2–3 months, before initial cannulation of an AV fistula. However, this long a wait is feasible only when there is no impending need for commencement of dialysis, which is quite often not the case. Furthermore, if it is observed that earlier cannulation practice is associated with good vascular access outcomes in some facilities, then it behoves the rest of the community to examine factors whereby earlier cannulation can be accomplished . . . [Full Text of this Article]



   Previous studies on vascular access practices and outcome: DOPPS
 


   Other recent studies on vascular access practices and outcome
 


   New DOPPS report on vascular access practices and outcome at facility level
 


   Conclusions
 

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