Characterization of Long-term Survival in Medicare Patients Undergoing Arteriovenous Hemodialysis Access

•Type of Research: Retrospective analysis of a large multi-institutional data•Key Findings: The 5-year mortality overall was 62.9% with 61.2% for AV fistulas and 68.8% for AV grafts (P<.001). On multivariable analysis for 5 year mortality, non-ambulatory status, lower extremity access, HIV/AIDS, White race, congestive heart failure, chronic obstructive pulmonary disease, and AV graft placement were most associated with poor survival. Factors associated with improved survival were never smoking, preoperative home living, and hypertension.•Take Home Message: Long-term survival in Medicare patients undergoing AV access creation is poor with nearly two-thirds of patients having died at 5 years. There are many modifiable risk factors that may improve survival in these patients and give an opportunity for transplantation.