Many chronic renal patients lack autologous veins in the upper limbs suitable for construction of arteriovenous fstulas for hemodialysis. Alternative fistula options for these patients should be evaluated and compared. The point of this examination is to analyze incredible saphenous unite and polytetrtafluroethelene(PTFE) joins utilized for brachio-axillary access in hemodialysis patients as far as their patency and confusions rates. The investigation was an imminent randomized controlled examination included 60 patients with a clinical analysis of end-stage renal disappointment (ESRF) requiring hemodialysis. Thirty patients were worked upon by saphenous join for brachio-axillary shunt while the other thirty patients were worked upon by manufactured unite (PTFE) for brachio-axillary shunt. Patients remembered for this investigation were between the ages of 18 and 80 years. They were conceded or alluded to the general medical procedure office, vascular unit, with a conclusion of (ESRF) requiring hemodialysis. Patients were missing appropriate venous framework for characteristic AVFs in both upper appendages, or bombed recently done AVFs.; Enrollment of qualified patients was between March 2018 and February 2019. Follow up was intended for first, sixth and twelfth months term. The patients were randomized into 2 gatherings Group (I); by utilizing incredible saphenous vein as a brachioaxillary dialysis get to and Group (II); by utilizing PTFE unite as a brachioaxillary dialysis get to.