The increasing awareness of creating an arteriovenous fistula for maintenance hemodialysis in rapidly growing end‐stage renal disease population has created a new challenge not only for the nephrologist but also for the entire medical community. The construction of multiple vascular accesses limits the available sites for hemodynamic monitoring, creating a barrier in providing optimal patient care. The new management dilemmas that have been raised need to be better recognized. There is a critical need for creating tools to educate not only the chronic kidney disease patients but also medical personnel from other specialties regarding the value and care of dialysis vascular access.