Vascular access morbidity and mortality: Trends of the last decade

Charmaine E. Lok, Robert Foley

Research output: Contribution to journalArticlepeer-review

152 Scopus citations


During the past decade, clear trends in the types of incident and prevalent hemodialysis vascular access can be observed. There has been a steady increase and recent stabilizaton of patients initiating hemodialysis with a central venous catheter, representing approximately 80% of all incident accesses. There has also been a steady increase in prevalent fistula use, currently greater than 50%within 4 months of hemodialysis initiation. Patient and vascular access related morbidity and mortality are reflected in the type of vascular access used at initiation and for long-term maintenance dialysis. There is a three- to fourfold increase in risk of infectious complications in patients initiating dialysis with a catheter compared with either a fistula or graft and a sevenfold higher risk when the catheter is used as a prevalent access. Procedure rates have increased two- to threefold for all types of access. There is a significant increased risk of mortality associated with catheter use, especially within the first year of dialysis initiation.

Original languageEnglish (US)
Pages (from-to)1213-1219
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Issue number7
StatePublished - Jul 2013


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