Volume 5 -Issue 4 patients with CVC may be related to catheter infection, catheter related septicemia, frequent admissions, inadequate dialysis related to insufficient blood flow and frequent interruption of dialysis due to venous stenosis or thrombosis [6][7][8]. Almasri J, et al. conducted a recent systematic review and meta-analysis of 200 studies. Of 875,269 vascular accesses, the primary patency at two years was higher for fistulas than for graft and catheters (55%, 50% and 40% respectively). The risk factors for lower patency rates were old age, female gender, diabetes and coronary artery disease. The two-year mortality was higher with catheters, followed by grafts and fistulas (26%, 17% and15%