The predominant types of vascular access for chronic dialysis patients are (A) the arteriovenous fistula and (B) the synthetic arteriovenous forearm graft. The first primary arteriovenous fistula is usually created by the surgical anastomosis of the cephalic vein with the radial artery. The flow of blood from the higher-pressure arterial system results in hypertrophy of the vein. The most common AV graft (depicted in green) is between the brachial artery and the basilic or cephalic vein. The flow of blood may be diminished in the radial and ulnar arteries because it preferentially flows into the low pressure graft. (From Sowinski KM, Churchwell MD, Decker BS. Hemodialysis and peritoneal dialysis. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy: A Pathophysiologic Approach, 9th ed. New York, NY: McGraw-Hill, 2014:668, with permission.) Source: Chronic and End-Stage Renal Disease, Pharmacotherapy Principles & Practice, 4e Citation: Chisholm-Burns MA, Schwinghammer TL, Wells BG, Malone PM, Kolesar JM, DiPiro JT. Pharmacotherapy Principles & Practice, 4e; 2016 Available at: https://ppp.mhmedical.com/DownloadImage.aspx?image=/data/books/1793/chis_ch26_f007.png&sec=120651261&BookID=1793&ChapterSecID=120651075&imagename= Accessed: October 10, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved