Only two published studies have assessed the effect of statins on AVF primary failure, with contrasting results. Pisoni et al. concluded that statins did not improve AVF maturation, using a retrospective analysis of 317 patients and pooling all statins together as a drug class. Unfortunately, this approach overlooks the potential pleiotropic effects of distinct drugs on AVF remodeling. Overcoming the limitations of Pisoni et al.'s study, the investigators recently published a manuscript evaluating the benefits of three different statins (atorvastatin, rosuvastatin and simvastatin) on AVF outcomes using a retrospective analysis of 535 patients. In this work done in collaboration with the University of Miami, the investigators found a highly statistical significant risk reduction (76%, odds ratio [OR] 0.18, p=0.005) of AVF primary failure by atorvastatin. No other statins significantly improved AVF maturation in this cohort. Interestingly, this study showed that atorvastatin is particularly beneficial for one-stage AVF (96% risk reduction, OR 0.03, p=0.005) and, that higher doses of the drug are associated with lower rates of primary failure in one-stage fistulas. Two more studies done by the same group, a prospective and another retrospective, also support this finding indicating that the use of statins prior to fistula creation is beneficial for the unassisted survival of the AVF.