ABSTRACT
The 1998 report of the U.S. Renal Data System indicates that nearly 300,000 Americans are currently being treated for end-stage renal disease (ESRD) (1). New cases of ESRD have increased dramatically over the past decade to over 41,000 per year of late (1). The annual mortality rate among dialysis patients remains high due to the advanced age and frequent comorbid conditions present; however, improvements in technology and patient care have extended the number of years patients receive dialysis. This patient population clearly represents a challenge to the physician who has the task of placing a well-functioning dialysis access route. Thoughtful patient evaluation and planning prior to an access procedure may lessen patient morbidity and discomfort and offer the maximal opportunity for a successful outcome and prolonged, uninterrupted access.
