The role of physical examination of HD access for the general nephrologist

Physical examination is emerging as an important tool in the evaluation of an arteriovenous access. Multiple studies have demonstrated that physical examination can accurately detect and localize stenotic lesions in a great majority of patients with an arteriovenous access. Importantly, recent data have emphasized that nephrologists can be easily trained and successfully acquire this skill. Because of its accuracy, non-invasive nature and cost-effectiveness, this tool should be employed by the nephrology community more frequently than it is practiced currently. Emphasis on physical examination by nephrology training programs as well as community medical centers is urgently needed.