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Invited Commentary
September 22, 2021

Building Systems to Measure Success and Improve Outcomes in Dialysis Access—Not a “Steal” but Probably a Bargain

Author Affiliations
  • 1Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
JAMA Surg. 2021;156(12):1119. doi:10.1001/jamasurg.2021.4528

Huber and colleagues1 provide a carefully curated accounting of the technical details, functional use, and 2-year outcomes for 602 patients who underwent creation of arteriovenous fistulas. The details in their article, especially related to the preoperative, intraoperative, and postoperative aspects of their cohort, are admirable—no fewer than 11 outcomes are evaluated in each patient, with exceptional detail about the multitude of steps necessary to keep a fistula patent and functional in these patients with complex conditions. These data, as the authors aptly outline in the discussion, provide among the best published benchmarks for performance after fistula creation in the US.

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