There are two types of access sites for dialysis patients.  Fats always take the easy way out.  They choose the chest catheter, a permanent tube that goes directly to their heart so they don't need needles into veins and whatnot. They can't deal with the pain lol. They can't stand the needles.  FIstulas are a vein and an artery sewn together for easy access and blood flow. It hurts but it is lot safer in the long run, no high risk of infection directly in the heart, you can shower and swim, and there's no tubes sticking out of your chest. This is what drs and nurses try really hard to make you go with a fistula and not a catheter.  All the fats choose the cath. Because it's pain free. They don't care if it'll kill them.  Source: Am dialysis patient.