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February 12, 1997

Vascular Access in Patients Receiving Hemodialysis

JAMA. 1997;277(6):455. doi:10.1001/jama.1997.03540300023013

To the Editor.  —Although more readily constructed in many patients needing vascular access for hemodialysis, AV grafts using synthetic material are more prone to thrombosis and infection than are native fistulas.1 Hirth et al2 made an important contribution by showing that the use of a graft vs a fistula on day 30 of hemodialysis depended on a number of clinical and nonclinical factors, including geographic region.2 To determine the use of fistulas vs grafts in US hemodialysis patients, we analyzed data from the National Surveillance of Dialysis-Associated Diseases, which is an annual mail survey of all US chronic hemodialysis centers. The survey is conducted by the Centers for Disease Control and Prevention (CDC) in collaboration with the Health Care Financing Administration (HCFA).3Dialysis centers reported the number of patients receiving chronic hemodialysis who were treated during December 25 to 31,1995, and the percentage of these patients treated with a