Lessons From International Differences in Vascular Access Practices and Outcomes

Ever since origination of the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines on vascular access management in 19971 and the Fistula First Initiative in 2002,2 vascular access research has exploded. Most publications derive from single-center studies3 or from analyses of multicenter vascular access studies, such as the Dialysis Access Consortium (DAC)4 and the Hemodialysis Fistula Maturation (HFM) Study.5 More substantial assessments arise from large administrative databases, such as the US Renal Data System (USRDS), that rely on mandatory reporting by dialysis units.

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