Compare Elbow mNT-BBAVF With Wrist RCAVF for Hemodialysis Access

Inclusion Criteria: 1. Patients with chronic kidney disease (CKD) stage 5 requiring hemodialysis (including pre-dialysis patients) and eligible for a native arteriovenous fistula; 2. Adult (age ≥ 18 years old); 3. Preoperative Doppler ultrasonography showing target vein diameter(s) ≥ 2.0 mm and target artery diameter(s) ≥ 2.0 mm; 4. Estimated life expectancy \> 1 year; 5. Written informed consent obtained; 6. Patient is free of clinically significant conditions or illness that may compromise the procedure within 30 days prior to AVF creation Exclusion Criteria: 1. Patients with a history of cerebral hemorrhage or gastrointestinal hemorrhage are excluded from the study; 2. New York Heart Association class III or IV heart failure; 3. Patients who are absent of median cubital vein and verified by preoperative Doppler ultrasonography are excluded from the study; 4. Known central venous stenosis, central vein narrowing \> 50% or deep vein thrombosis based on imaging on the same side as the planned AVF creation; 5. Prior arm surgically created access in the planned treatment arm; 6. Immunosuppression (i.e. use of immunosuppressive medications to treat an active condition).