Hemodialysis is the commonest renal replacement therapy worldwide. Types of hemodialysis access include central venous catheter (CVC), arteriovenous grafts (AV graft) and arteriovenous fistulas.

The routine use of central venous catheters should be avoided due to the high complication rates associated with catheters, which includes infection and malfunction. In comparison to AVG, AVF, the latter offer superior long-term primary patency and lower infection rates and as such is the dialysis vascular access of choice. As time is required for AVF to mature after creation, patients should be referred to a surgeon for evaluation of an AVF creation by Stage 4 (glomerular fi ltration rate (GFR) less than 30 mL/min/1.73 m 2 ) Chronic Kidney Disease.CVC are not indented for permanent use and are usually used in patients without AV fistula.

An AVF is created by anastomosing a vein to the artery. In order of preference, the radiocephalic AVF is preferred;followed by the brachiocephalic AVF and the transposed brachial basilic vein fistula.

Pre-operative imaging is essential in selection of the type and location of the hemodialysis access.