Dahlerus C, et al. - In this retrospective cohort study, researchers characterized variation in facility-level use of arteriovenous fistulas (AVFs) across the facility-level burden of patient comorbid conditions. Overall, the use of AVF was 65.8% among 5,813 facilities in 315,919 prevalent patients with hemodialysis. According to findings, small variations were found in facility rates of AVF use except in the extremes of high or low levels of comorbidity burden after adjustment for patient characteristics. Findings reveal that dialysis facilities with a relatively high patient comorbidity burden can achieve comparable rates of a fistula to facilities with healthier individuals. While high comorbidity burden does not explain low AVF use facilities, further research is required to understand differences in AVF use rates among facilities with comparable comorbidity burdens.