What type of access has the lowest complication rate?

The type of access that has the lowest complication rate is a fistula. A fistula is created surgically by connecting an artery and a vein, usually in the arm. This results in a durable and effective means for obtaining vascular access for dialysis treatments. Fistulas are preferred because they tend to have lower rates of infection, thrombosis, and other complications compared to other access methods.

Additionally, a well-functioning fistula can remain usable for many years, which is beneficial for patients who require long-term dialysis treatment. The body recognizes a fistula as a natural vascular structure, which contributes to its longevity and effectiveness.

In contrast, central venous catheters and dialysis catheters can be more prone to complications such as infections or clotting, while grafts, although useful, typically have a shorter lifespan and a higher complication rate than fistulas. This combination of factors underscores why a fistula is considered the best option regarding complication rates in dialysis access.