In 2009 we generated some statistics from examining my own practice: (1) a 50-60 percent fistula maturation rate (reported from national studies) can be bettered in a dedicated vascular access practice such as mine – maturation rates vary from 78% (wrist fistulas) to 96% (transposed basilic fistulas); (2) and rather than 6 months, most fistulas can be cleared for use from an average of 62 days (one-stage brachiocephalic fistulas) to 113 days (two-stage transposed basilic fistulas).
The value of these data are threefold: first, that the 50-60% maturation rate of fistulas reported nationally can be bettered in focused surgical practices focusing on dialysis accesses, meaning that a 50/50 success rate should no longer be considered acceptable; secondly that a 80-95% success rate rather than 50% means that multiple access attempts should be needed less often, getting the catheters out faster; and finally, the fact that normal fistulas can be matured in less than three months means that knowledgeable aggressive follow-up does pay off, and that procrastination does not.
