Contemporary societies are in the midst of an epidemic of chronic non communicable diseases including that of chronic disease (CKD). India is no exception to this rule. Hemodialysis is still the main treatment given for patients of Chronic Kidney Disease, although renal transplantation is slowly changing the trends with better immunosuppression and better surgical techniques with wider acceptance of the masses. The provision of effective and timely hemodialysis requires a stable and reliable vascular access. Thus, vascular access is not only the obvious 'Achilles heel' of hemodialysis (HD) but it is also the quiet undercurrent of trends in patient outcomes. Data on the comparisons between various angioaccess are very limited in literature. So we undertook a study to compare the various angioaccess used for hemodialysis in patients of CKD. Key Word: CKD- Chronic Kidney Disease, HD- Hemodialysis 3 This global prevalence, however, may be grossly underestimated for a number of reasons. Patients with CKD are at high risk for cardiovascular disease (CVD) and cerebrovascular disease (CBVD), and they are more likely to die of CVD than to develop end-stage renal failure. Moreover, patients with CVD often develop CKD during the course of their disease, which may go unrecognized. Therefore, an unknown proportion of people whose death and disability attributed to CVD have disease as well. 4 Moreover, most epidemiological data (prevalence, incidence, patient demography, morbidity, and mortality) on CKD are derived from renal registries. However, most registries record data of patients who are at late stage of disease. Much less is known about the prevalence of the earlier stages of the CKD. Indeed, it has been acknowledged that the majority of the individuals at early stages of CKD have gone undiagnosed and under treated. 4 The number of end stage of renal disease patients that need dialysis or renal transplantation increased in the world. The overall magnitude and pattern of chronic disease (CKD) in India has been studied sporadically. The CKD Registry of India is a new initiative that has been started to document CKD and its course in our country. Modern haemodialysis therapy started on 17 March 1943, when Willem Kolff, a young doctor in the small hospital of Kampen (The Netherlands), treated a 29-year-old housemaid suffering from malignant hypertension and contracted kidneys. Kolff had constructed a rotating drum kidney with the support of Mr Berk, the director of the local enamel factory. First, Kolff used only venipuncture needles to obtain blood from the femoral artery and to reinfuse it by puncturing a vein. Later, he performed surgical cut-down of the radial artery which caused severe bleeding during heparinization.