CIMRO of Nebraska is working in partnership with the End Stage Renal Disease (ESRD) Network 12 (serving Nebraska, Iowa, Kansas and Missouri) in support of  a national initiative to increase the use of  AV fistulas as the primary vascular access in providing hemodialysis for Medicare beneficiaries with kidney failure, which is also known as end stage renal disease.

Hemodialysis is the most common treatment for ESRD. During a hemodialysis treatment, a machine pumps blood from the patient’s body, cleans it of waste products and then returns it to the patient’s bloodstream. A fistula is a "connection" surgically created by joining a vein and an artery in the forearm that allows blood from the artery to flow into the vein and provide access for dialysis. The higher blood pressure in the artery forces blood into the vein and safely enlarges the vein, creating a good site for the large gauge dialysis needles at the end of the flexible blood transport tubes.

For quality improvement resources and strategies, please view the Fistula First Documents and Links sections.