The "Femoral First" Initiative

The "fistula first" initiative is a push to have more arteriovenous fistulas placed in chronic kidney disease patients prior to their first dialysis session. (This is the best way to receive hemodialysis.)

At an institution where many first dialysis sessions are performed in patients with poor access to medical care, I heard a nephrology fellow wryly refer to the "catheter first" or "femoral first" initiative. (This is the worst way to receive hemodialysis.)