ABSTRACT
Complications associated with surgically created arteriovenous (AV) access fistulae and grafts represent a significant source of morbidity and mortality in patients maintained on hemodialysis. A recent review of the Medicare End Stage Renal Disease (ESRD) Program database illustrates the magnitude of this problem (1). This database represents approximately 200,000 patients comprising 90% of ESRD patients in the United States. In 1986, access-related complications resulted in 29,741 hospital admissions, accounting for more than 17% of all hospitalizations in this population. From 1984 to 1986, the total number of accessrelated hospital days increased from 189,000 to over 208,000. During a 2-year period, 19% of patients on hemodialysis experienced an access-related complication requiring hospitalization, with a mean hospital stay of 7 days.
