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Editorial
May 14, 2008

Randomized Trials in Hemodialysis PatientsTime to Step Up to the Plate

Author Affiliations

Author Affiliations: Alberta Kidney Disease Network and Department of Critical Care, University of Alberta, Edmonton, and Institute of Health Economics, Edmonton, Alberta, Canada.

JAMA. 2008;299(18):2205-2207. doi:10.1001/jama.299.18.2205

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

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