The National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for hemodialysis vascular access since 1996. Since the last update in 2006, there has been a great accumulation of new evidence and sophistication in the guidelines process. The 2019 update to the KDOQI Clinical Practice Guideline for Vascular Access is a comprehensive document intended to assist multidisciplinary practitioners care for chronic kidney disease patients and their vascular access. New topics include the end-stage kidney disease “Life-Plan” and related concepts, guidance on vascular access choice, new targets for arteriovenous access (fistulas and grafts) and central venous catheters, management of specific complications, and renewed approaches to some older topics. Appraisal of the quality of the evidence was independently conducted by using a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and interpretation and application followed the GRADE Evidence to Decision frameworks. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.

国家肾脏基金会的肾脏疾病结果质量倡议 (KDOQI) 自 1996 年以来一直为血液透析血管通路提供循证指南。自 2006 年上次更新以来，指南过程中积累了大量新证据和复杂性。KDOQI 血管通路临床实践指南的 2019 年更新是一份综合文件，旨在协助多学科从业者护理慢性肾病患者及其血管通路。新主题包括终末期肾病“生命计划”和相关概念、血管通路选择指南、动静脉通路（瘘管和移植物）和中心静脉导管的新目标、特定并发症的管理以及一些老年人的新方法主题。证据质量的评估是通过使用建议评估、制定和评价分级（GRADE）方法独立进行的，并且解释和应用遵循GRADE证据到决策框架。在适用的情况下，每项指南声明均附有基本原理/背景信息、详细理由、监测和评估指南、实施注意事项、特别讨论以及对未来研究的建议。