UP FRONT MATTERS: JASN Debates

Resolved: Fistulas Are Preferred to Grafts as Initial Vascular Access for Dialysis

Anatole Besarab ¹, Michael Allon ^*1, and Michelle L. Robbin

Division of Nephrology and Hypertension, Henry Ford Health System, Detroit, Michigan

¹ To whom correspondence should be addressed. E-mail: abesara1{at}hfhs.org,.

	Abstract

There is growing concern that the Fistula First Initiative, KDOQI guidelines, and subsequent pressure from the Centers for Medicare and Medicaid Services lack reasonableness regarding likely success for fistula maturation in a heterogeneous, new-onset dialysis population. Here the various positions are examined from multiple perspectives.