A 71-year-old man who had been on hemodialysis therapy for 15 years began experiencing repeated swelling, erythema, and pruritus around his arteriovenous fistula (AVF) during the last 3 years. He received 5 hours of hemodialysis using a polysulfone membrane (Asahi Kasei Corp) 3 times weekly. The AVF, located in his left forearm, was accessed using a 16-gauge hemodialysis cannula. A lidocaine patch was used to alleviate pain associated with accessing the AVF. Before inserting the cannula, the site was cleaned with an antiseptic swab containing chlorhexidine.