What is considered the "gold standard" for dialysis access?

The arteriovenous (AV) fistula is considered the "gold standard" for dialysis access due to several important factors. An AV fistula is created by surgically connecting an artery to a vein. This method allows for a high blood flow rate, which is essential for effective dialysis treatment, and it typically has a lower risk of complications compared to other access methods.

One of the key advantages of an AV fistula is its durability; it can last for many years when properly cared for, making it a long-term solution for patients requiring chronic dialysis. Additionally, AV fistulas have a lower incidence of infection and thrombosis compared to central venous catheters, thus leading to better overall patient outcomes.

In contrast, other access methods such as central venous catheters, dialysis ports, and external shunts come with higher risks of complications and are usually considered temporary or less effective solutions. Central venous catheters, for example, are often used for immediate access but are prone to infection and can damage veins over time. Therefore, while other options may be available, the AV fistula stands out as the preferred choice for reliable, long-term dialysis access.