Transitioning dialysis patients from catheter to permanent access

There is no doubt that we have made great progress with Fistula First. When this mandate started, the renal community was at a 32% fistula rate. We have done a good job of bringing that up to a 60% rate for prevalent patients, wit hgoals of 65-70%.The current problem is stagnation. Other countries are doing better. In Europe, it is a cultural view that patients get a permanent access as soon as possible. And they get more training on placing better accesses. U.S. surgeons get the least amount of training in vascular access placement.