ArticleCardiovascular engineering and technology2017
Fistula First Initiative: Historical Impact on Vascular Access Practice Patterns and Influence on Future Vascular Access Care.
Article in Cardiovascular engineering and technology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
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Who cites it
48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- UK Kidney Association Clinical Practice Guideline on vascular access for haemodialysis.BMC nephrology · 2025Guideline
- Interventions for thrombosed haemodialysis arteriovenous fistulas and grafts.The Cochrane database of systematic reviews · 2024Pooled it
- Substitution of citrate with tissue plasminogen activator (rt-PA) for catheter lock does not improve patency of tunnelled haemodialysis catheters in a randomised trial.BMC nephrology · 2021Trial
- Vascular Access Management in Patients on Catheter-Based Hemodialysis.Journal of clinical medicine · 2026Article
- Facilitators and Barriers to Patient Enrollment in the Arteriovenous Access Trial of Vascular Access Outcomes: A Qualitative Study.Kidney360 · 2026Article
- Impact of Arteriovenous Access Formation on Cardiac Structure and Function in Hemodialysis Patients.Annals of vascular diseases · 2026Article
- Arteriovenous fistulas are associated with superior outcomes in very elderly hemodialysis patients: a nationwide cohort study.The Korean journal of internal medicine · 2026Article
- Predialysis Nephrology Care Disparities and Incident Vascular Access Among Hispanic Individuals.JAMA network open · 2025Article
- Quality Metrics in Dialysis: A Welcome Change for Vascular Access.Advances in kidney disease and health · 2025Review
- Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt.BMC nephrology · 2025Article
- Cellular and molecular mechanisms underlying hemodialysis arteriovenous fistula dysfunction and approaches to promote maturation: a vascular perspective.American journal of physiology. Heart and circulatory physiology · 2025Review
- Predicting long-term patency of radiocephalic arteriovenous fistulas with machine learning and the PREDICT-AVF web app.Scientific reports · 2025Article
- Safety and efficacy of a new covered stent in hemodialysis vascular access outflow stenosis: A Brazilian multicenter retrospective study.The journal of vascular access · 2025Article
- Associations between initial dialysis access types and death from dialysis withdrawal in incident patients with kidney failure.Clinical kidney journal · 2025Article
- Efficacy and safety of paclitaxel drug-coated balloon angioplasty for stenosis of hemodialysis vascular access: 6-month results from a brazilian multicenter prospective study.Jornal vascular brasileiro · 2025Article
- Robotic tomographic ultrasound and artificial intelligence for management of haemodialysis arteriovenous fistulae.The journal of vascular access · 2025Article
- Venous distensibility may be an indicator of early arteriovenous fistula failure, a retrospective single-centre cohort study.Renal failure · 2024Article
- Temporal trends in hemodialysis access creation during the fistula first era.Journal of vascular surgery · 2024Article
- Global variations in funding and use of hemodialysis accesses: an international report using the ISN Global Kidney Health Atlas.BMC nephrology · 2024Article
- Vascular Access Perception and Quality of Life of Haemodialysis Patients.Journal of clinical medicine · 2024Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
Abstract
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative". However, an AVF may not be the best vascular access in all hemodialysis patients, and arteriovenous grafts (AVG) and CVCs may be appropriate and the best access for a subset of hemodialysis patients. Unfortunately, there still remains very little emphasis within vascular access initiatives and guidelines directed towards evaluation of the individual patient context, specifically patients with poor long-term prognoses and short life expectancies, patients with multiple comorbidities, patients who are more likely to die than reach end stage renal disease (ESRD), and patients of elderly age with impaired physical and cognitive function. Given the complexity of medical and social issues in advanced CKD and ESRD patients, planning, selection, and placement of the most appropriate vascular access are ideally managed within a multidisciplinary setting and requires consideration of several factors including national vascular access guidelines. Thus, the evolution of the FFBI should underscore the need for multidisciplinary health teams with a major emphasis placed on "the right access for the right patient" and improving the patient's overall quality of life.
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Registered trials
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