Do you recommend placement of a backup AV fistula in an advanced CKD patient who is planning to do peritoneal dialysis?   

This is a controversial point for which I don't believe there to be great data. An old study in the British literature- I can't get my hands on it right now- purportedly demonstrated that only 7% of such fistulae were ever used/ useable. With improved fistula technique and survival this number is un...

I asked the same question on ASN open forum and Dr. Joanne Bargman compared this to walking down the aisle with your loved one on one side and a divorce lawyer on the other side. I don't see any reason to put an AVF as a backup on a patient who is just starting PD. AVF surgery is not without r...

Yes, absolutely. Can’t tell you how many patients who have avoided the dreaded CVC and/or a hospitalization by doing this.

I would consider establishing a vascular access in PD patient at the outset. Many PD patients for several reasons may need a backup HD support even for a few weeks of rest from PD. If there is a mature vascular access available, it would avoid placement of a temporary or tunneled venous access. ...