Vascular access surveillance: time to end the controversy

The establishment and maintenance of permanent vascular access for hemodialysis patients are important clinical problems. Vascular access surveillance, currently mandated by the CMS, refers to the task of identifying and correcting an underlying vascular access stenosis to prolong vascular access patency and survival. While this premise makes intuitive sense, this article discusses the underlying evidence to support it, outlining disparate conclusions of clinical practice guidelines and a recent commentary by experts in vascular access.