The 2005 revision to the Medical Evidence Report added fields regarding vascular access technique at the first outpatient dialysis session, including the use of a venous catheter in the presence of a maturing permanent access.
Between 2008 and 2011, roughly three of four patients initially dialyzed with a venous catheter, although 17 percent of such patients had a maturing permanent access. In 2011, however, there were new highs in the prevalence of patients initially dialyzing with a permanent access, reaching more than 18 percent in August, 2011.
Among very elderly patients, initiation of outpatient dialysis with a venous catheter was relatively more likely. The extent to which this reflects lack of preparation for hemodialysis versus careful consideration of the probability of access maturation deserves further scrutiny, as life expectancy after dialysis initiation remains low in this subset of patients.