Various chronic kidney diseases (including various glomerulonephritis, hypertensive nephropathy, diabetic nephropathy, etc.) can impair kidney function. With the development of kidney lesions, kidney function can progressively diminish, eventually leading to chronic renal failure. However, scientific treatment can slow down or control the rate of progression of renal function damage. When the kidney disease develops to a certain level and the kidney function decreases to only 25% of normal, even if the underlying disease has stopped its activity, the kidney function will continue to decrease incessantly by some means until uremia occurs. This is the objective law of disease development, which cannot be changed. Therefore, for patients in renal failure (i.e., when the glomerular filtration rate is reduced to less than 25% of normal), early preparation for renal replacement therapy is necessary. The current renal replacement therapy mainly includes hemodialysis, peritoneal dialysis and kidney transplantation. In China, hemodialysis is the most common. The so-called hemodialysis refers to the artificial purification of blood outside the patient’s body and its return to the patient’s body. During dialysis, the flow of blood in the extracorporeal circulation reaches 250 ml per minute, while the blood flow in the arm veins is usually only tens of ml, which is far from enough to meet the needs of dialysis, and the walls of the veins are thin and cannot withstand repeated punctures of the dialysis needles. Therefore, several months before dialysis, an autologous arteriovenous endovascular fistula should be performed. The radial artery of the patient’s wrist is connected to the cephalic vein, so that the arterial blood will directly impact into the venous wall for a long time, resulting in the increase of local venous blood pressure and the thickening and expansion of the venous wall. Due to the diameter and anatomical characteristics of the patient’s carpal arteries and veins affect the maturation time of the endovascular fistula. Forced endovascularization of vessels that are less anatomically suitable for endovascularization has little chance of success. However, if the procedure is performed one year earlier based on the expected start of dialysis, there is sufficient time to ensure maturation of the endovascular fistula. Moreover, if the procedure fails, there is time to perform another vascular access, which avoids the use of central venous cannulae. In particular, patients with diabetes, coronary artery disease, hypertension, and advanced age should undergo endovascular fistuloplasty early because most of them have vascular damage. For patients who may require endovascular fistula, care should be taken to protect their limb veins. The limb veins, especially the non-dominant cephalic veins, should be avoided as much as possible and venipuncture or venous cannulation should not be performed. This is because complications from venipuncture may make the corresponding vein no longer suitable for endovascular fistuloplasty. Dorsal hand veins should be used when infusion therapy is required, and care should be taken to change puncture sites when limb veins have to be used. Puncture and cannulation of limb veins should be avoided when the patient’s creatinine is greater than 265 mmmol/L. In addition, subclavian cannulation should be avoided in all patients with chronic renal failure because of the risk of central venous stenosis, which can interfere with the establishment of vascular access on the same side. In addition, since dialysis treatment is a long-term process that can sustain the patient’s life for up to 30 years, active patient cooperation during treatment is very important. Therefore, patients with renal insufficiency should visit a nephrologist as early as possible to learn about dialysis, self-care points of kidney disease, dietary regimen and other related knowledge, so as to better cooperate with the physician’s treatment and win a lasting and better quality of life for themselves.