Background: The inability of a newly created arteriovenous fistula to support hemodialysis due to non-maturation results in increased complications secondary to catheter dependence.
Methods: In view of the highly variable approaches by providers with heterogenous backgrounds (general surgery, vascular surgery, interventional radiology and interventional nephrology, urology, transplant surgery, etc.) we sought to describe a collection of algorithms that have functioned well in our hands to manage this challenging clinical problem and guide trainees and practicing clinicians alike.
Results: Physical examination along with selective duplex ultrasound and fistulogram can identify most pathologies underlying non-maturation.
Conclusion: Both endovascular and open techniques can be employed to optimize maturation rates in this complex population.
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