Improving outcomes in dialysis fistulae

One of the great medical successes in recent years has been the reduction in the number of patients waiting for a kidney transplant. In 2009, 7190 people were on the waiting list in the UK, and in June, 2016, this number had decreased to 5116. 1 Nevertheless, many people on the list can expect to wait for years, and many patients with end-stage renal failure are never suitable for transplantation because of comorbidities and remain instead on dialysis. As such, a substantial demand exists for dialysis access surgery; in the USA, 105 923 patients initiate haemodialysis annually 2 and in the UK, more than 4000 vascular access procedures are done each year to facilitate haemodialysis. 3 These operations are mostly to create arteriovenous fistulae, which are the recommended form of vascular access. 4