Vascular Access In CKD

KDOQI Guidelines state:

In patients with CKD stage 4 or 5, forearm and upper-arm veins suitable for placement of vascular access should not be used for venipuncture or for the placement of intravenous (IV) catheters, subclavian catheters, or peripherally inserted central catheter lines (PICCs). (B) 1.3 Patients should have a functional permanent access at the initiation of dialysis therapy.

  • 1.3.1 A fistula should be placed at least 6 months before the anticipated start of HD treatments. This timing allows for access evaluation and additional time for revision to ensure a working fistula is available at initiation of dialysis therapy. (B)
  • 1.3.2 A graft should, in most cases, be placed at least 3 to 6 weeks before the anticipated start of HD therapy. Some fewer graft materials may be cannulated immediately after placement. (B)

Following these guidelines creates a smooth transition from CKD to dialysis. Imagine how difficult it is for dialysis facility staff to get a permanent accesses placed when they have to work around dialysis schedules and transportation issues. Many times the patients become “attached” to their catheters and are reluctant to give them up which makes it even more difficult for dialysis facility staff to get a permanent access placed.

During this 3 month campaign we will be providing CKD best practices, resources and patient stories to you bi-weekly starting (DATE). The goal of the campaign is to provide a strong focus on early planning and placement of AV Fistula as the best way to improve vascular access outcomes for our patients and give you a business case model incentive for improving vascular access incident rates.

Download the current campaign edition below:





The Renal Network
911 E. 86th Street, Suite 202
Indianapolis, IN 46240
Phone: (317) 257-8265
Fax: (317) 257-8291
Patient Line:
1 (800) 456-6919
Email: [email protected]

Last updated on: September 19, 2014