Chronic hemodialysis therapy required regular entry into the patient's blood stream with adequate flow. The use of arteriovenous fistulas and grafts is linked with lower morbidity and mortality than the use of catheters. However, these types of accesses are frequently affected by stenoses, which decrease the flow and lead to both inadequate dialysis and access thrombosis. The idea of duplex Doppler ultrasound surveillance is based on the presumption that in-time diagnosis of an asymptomatic significant stenosis and its treatment prolongs access patency. Details of performed trials are conflicting, and current guidelines do not support ultrasound surveillance. This review article summarizes the trials performed and focuses on the reasons of conflicting results. We stress the need of precise standardized criteria of significant access stenosis and the weakness of the metaanalyses performed.

3rd Department of Internal Medicine General University Hospital and 1st Faculty of Medicine Charles University Prague Czech Republic

Center for Vascular Access General University Hospital and 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Internal Medicine Leiden University Medical Center The Netherlands

Department of Nephrology Clinical Hospital Centre Zemun Belgrade Serbia

Division of Nephrology Miulli General Hospital Acquaviva delle Fonti Italy

Institute of Life Sciences Sant'Anna of Advanced Studies and Department of Internal Medicine Pisa University Pisa Italy

Nephrology Department Parc Taulí University Hospital Parc Taulí Research and Innovation Institute Autonomous University of Barcelona Barcelona Spain

School of Medicine University of Belgrade Belgrade Serbia

Service of Vascular Surgery Department of Heart and Vessels University Hospital Lausanne Switzerland

Vascular Access Clinic Asklepios Clinic Barmbek Hamburg Germany

Vascular Laboratory Bravis Hospital Bergen op Zoom The Netherlands

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