Even as we speak chronic kidney failure is taking a huge toll on lakhs of families in India. This is unfortunate because kidney failure is the easiest of all organ failures to manage. We have dialysis which can replace kidney function to a significant extent and kidney is the easiest solid organ to transplant. This sad situation is because of a number of factors, the most important of which is the lack of awareness at all levels of the society. Compared to similar patients in the developed world or even some other developing countries, kidney failure patients have extremely poor outcomes in India. As things today we are not even addressing the tip of the iceberg. In the past, one of the major problems and causes of failure in Hemodialysis (HD) was represented by the lack of good vascular access (VA). Obtaining vascular access is one of the most difficult problems associated with HD. To carry out HD, a very rapid blood flow is required and access to a large blood vessel is essential. After the introduction of the fistula, in the last few decades, the advent of prosthetic Arteriovenous graft (AVG) and central venous catheters (CVCs) has given physicians the opportunity to choose the most appropriate VA for HD patients. However, the native AVF remains the first choice for VA, especially because of the infectious and thrombotic complications more frequently associated with AVGs and CVCs 

Keywords: Dialysis; Hemodialysis; Vascular Access; Arteriovenous Graft