The fifth issue is the absence of a permanent access at the start of renal replacement therapy. Cost implications of elective vascular access placement We also know that elective outpatient vascular access placement costs less. Further, arterial venous grafts are more likely to require revision than fistulae. Here are the proportions of fistulae that required revision over a period of 1.6 years. This bar shows you the number of grafts.
Grafts require revision twice as often as fistulae.
A full 47 percent of patients said that they received no such instructions to protect the arm for a vascular access. Further, the majority of patients start renal replacement therapy without a permanent vascular access. You will see that 48 percent of patients who started dialysis neither had a permanent access placed nor attempted prior to the start of renal replacement therapy. The majority of patients who start dialysis in the U.S. have uremic symptoms for several months prior to the start of renal replacement therapy. Two-thirds of these patients who start dialysis in the U.S. have had nausea, vomiting, and other uremic symptoms for several months prior to the start of dialysis.