Which hemodialysis access site is associated with a lower risk of vascular access-related infections?

• A. Arteriovenous fistula
• B. Arteriovenous graft
• C. Peripherally inserted central catheter
• D. Central venous catheter

Answer: (A)

Using a patient’s own blood vessels without any artificial material typically carries the lowest risk of infection. An arteriovenous fistula is created from native vessels and does not involve implanted foreign material, so there are fewer surfaces for bacteria to cling to and fewer opportunities for bloodstream infection. In contrast, an arteriovenous graft uses synthetic material to connect artery and vein, which provides surfaces that can harbor bacteria and biofilms, raising infection risk. Central venous catheters, including those placed peripherally or centrally for dialysis, create direct access to the bloodstream and often have external components, making infections more likely. Therefore, among these options, the fistula has the lowest vascular access–related infection risk.