Creation (Access Construction)‍ ‍‍ ‍

• Arteriovenous fistula (AVF): Preferred long-term access created using the patient’s own arteries and veins. Offers the best durability and lowest infection risk.

• Arteriovenous graft (AVG): Uses a synthetic conduit when native veins are unsuitable. Provides reliable access with earlier use compared to some fistulas.

• Peritoneal dialysis catheter placement (PD): Surgical insertion and securement of a catheter in the abdomen for patients choosing peritoneal dialysis.

• Central venous catheter (CVC): A flexible tube placed into a large central vein. Catheters are used for short-term or urgent dialysis needs or when other access types are not feasible. They are associated with the highest rates of infection and other complications.

Repair (Access Revision and Salvage) ‍‍ ‍

• Thrombectomy and thrombolysis: Removal or chemical dissolution of clots to restore flow.

• Surgical revision: Repair of stenosis, aneurysm, pseudoaneurysm, or flow problems to prolong access life.

• Infection management: Removal and replacement of infected grafts or catheters when necessary, combined with targeted antibiotics.

Maintenance (Surveillance and Endovascular Treatments) ‍ ‍

• Routine monitoring: Physical exam, access flow measurements, and duplex ultrasound to detect dysfunction early.

• Endovascular interventions: Percutaneous transluminal angioplasty and stent placement to treat stenosis and preserve function.

• Catheter care: Education and protocols for dressing changes, aseptic handling, and timely catheter exchange to reduce infection risk.

Patient-Centered Care ‍ ‍

• Individualized access planning based on vascular anatomy, dialysis needs, comorbidities, and lifestyle.

• Preoperative mapping and imaging to select the optimal access site.

• Education on access use and self-care, signs of complications, and when to seek urgent care.