Abstract: Objective To investigate vascular access used at the start of hemodialysis of end stage of renal disease（ESRD）patients，arteriovenous ?stula（AVF）or central venous catheters（CVCs）, and analyse the causes of without using AVF. Methods Incident patients with ESRD starting hemodialysis between 1 October 2007 and 30 September 2012 were included in the study. To investigate vascular access used at the start of hemodialysis. The clinical data were collected to analyse the causes of without using AVF. Results A total of 160 patients were included in this study. Hemodialysis started with a AVF in 32 patients and with CVCs in 128 patients. Using CVCs were associated with older age, higher CCI, higher eGFR and lower Hb levels. There were more patients with heart failure and emergency start, less patients with nephrology follow-up in CVCs group. The two main causes of using CVCs were without transfer to the nephrology and delayed planning of vascular access. Conclusions Most ESRD patients started hemodialysis without a AVF. Multiple causes were associated with this fact, many of which are modi?able.

Key words: Hemodialysis, Vascular access, Arteriovenous ?stula, Central venous catheters