1. Patient is willing to comply with all study procedures for the duration of the study 2. Patient has a diagnosis of ESKD 3. Patient initiated hemodialysis at least 90 days prior to the planned surgical procedure 4. Patient is treated with a stable hemodialysis schedule, defined as an average of 2.5- 3.5 hemodialysis sessions per week in the preceding 4 weeks prior to surgery 5. Patient is scheduled to undergo nonemergent surgical procedures in the Stanford Health Care system. This includes (but is not limited to): - Fistula or graft creation, revision, or removal - Fistulogram - Peritoneal dialysis catheter placement or revision - Lower extremity angiogram (including femoral and iliac vessels) - Lower extremity bypass (including femoral and iliac vessels) - Lower extremity amputation - Lower extremity endarterectomy (including femoral and iliac vessels) Of note, this list of procedures is not exhaustive and other procedures may be considered that meet inclusion criteria and no

, in consultation with the treatment teams involved. Exclusion Criteria: 1. Patient is pregnant 2. Patient is a prisoner 3. Patient is < 18 years old 4. The treating clinicians determine that the patient's clinical condition necessitate a specific approach to surgical scheduling or preoperative hemodialysis