Which type of access is preferred for long-term hemodialysis?

A vascular access fistula is the preferred type of access for long-term hemodialysis due to its numerous benefits. Fistulas are created by connecting an artery to a vein, which allows for increased blood flow and can handle the high pressures required during dialysis treatments. They tend to have better longevity compared to other types of access, with a lower risk of complications such as infection and thrombosis. Fistulas also promote the maturation of the vein, providing a stronger and more reliable site for needle insertion.

In contrast, a central venous catheter, while useful for short-term access, carries a higher risk of infection and can become occluded over time. A peripheral IV line is not suitable for long-term use in dialysis because it cannot provide the necessary blood flow and is also subject to complications like phlebitis. Jugular vein access, although sometimes used in acute situations, similarly poses risks related to internal jugular placement and potential complications, making it less favorable for ongoing hemodialysis compared to a well-functioning vascular fistula.