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February 12, 1997

Vascular Access in Patients Receiving Hemodialysis

Author Affiliations

Tulane University Hospital and Clinic New Orleans, La

JAMA. 1997;277(6):455-456. doi:10.1001/jama.1997.03540300023014

To the Editor.  —The article on vascular access by Hirth et al1 and the Editorial by Chertow2 suggest that surgeons and nephrologists are not serving the best interests of their patients by the excessive use of polytetrafluoroethylene (PTFE) grafts in creating vascular access for chronic hemodialysis. We agree that physicians exert a critical influence on the choice of an AVF over a PTFE graft. Hirth et al1 calculate that 25% of surgeons accounted for 95% of all AVFs. Unfortunately, the critical statistic needed to support their