Fig 2. An algorithmic guide to choosing an appropriate hemodialysis vascular access for patients.

This protocol requires the nephrologist and access surgeon to consider three important clinical factors: timing of access surgery relative to initiation of hemodialysis, life-expectancy of the patient, and prior failed vascular access. This information, along with the likelihood of AVF non-maturation, is used to determine the most appropriate vascular access for that patient: fistula (F) or graft (G). Reproduced with permission from³⁷.