Author Affiliations: Alberta Kidney Disease Network and Department of Critical Care, University of Alberta, Edmonton, and Institute of Health Economics, Edmonton, Alberta, Canada.
Hemodialysis requires a reliable conduit to transport blood from the patient to the dialysis apparatus and back again, which is usually termed “vascular access.” Establishing and maintaining vascular access is time-consuming, difficult, and expensive—access creation and complications are the most common causes of hospital admissions in patients with end-stage renal disease,1 at an estimated annual cost of more than $1 billion in the United States alone.2 Accordingly, vascular access has been termed the “Achilles' heel” of hemodialysis.3
Tonelli M. Randomized Trials in Hemodialysis PatientsTime to Step Up to the Plate. JAMA. 2008;299(18):2205-2207. doi:10.1001/jama.299.18.2205