A person who has kidney failure, or ESRD, should be cognizant that the choices s(he) and their physician make regarding their care will effect their life expectancy.
For example, a study comparing Dialysis treatment in Italy and the U.S. points out that in 2006, the annual mortality rate for people with ESRD in Italy was 11.2+/-.6 compared to 24% in the U.S. A link to the abstract of the article can be found here.
The authors write, in part, that "[t]he following may explain the low mortality for ESRD patients in Italy: low prevalence of diabetes, high use of AV fistulae, delivery of care by nephrologists beginning in pre-ESRD stages, their involvement in placement of dialysis vascular access, and their physical presence requirement during dialysis sessions."
Keep in mind, as of 2006, only 38.6% of dialysis patients had AV fistulas compared to approximately 82% of dialysis patients in Italy (figures taken from the study cited above). Recent data is much more encouraging. As of December 2010, in the U.S., 57.5% of hemodialysis patients had AV Fistulas. See here.
AV fistulas are associated with lower infection rates compare to people with AV grafts and thus better long term outcomes for the patient.
A Veterans Administration study linked to here also found that people on hemodialysis who had AV fistulas lived on average about 3 months longer compared to people with AV grafts.
The bottom line is by studying the various manners of treatment for ESRD both domestically and internationally, ESRD best-practices guidelines can be fashioned to increase the life expectancy and the quality of life for people on dialysis.
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