In 2013, the Blood Purification Center of Hospital A established a system to prevent shunt stenosis through team efforts. In addition to reinforcing the monitoring system for early detection and treatment of abnormal shunts, we created an order form for Vascular Access (VA) testing and a scoring sheet for shunt-related troubles by referring to the preexisting form. As a result, there was an increase in the number of patients undergoing contrast imaging for the early phase of shunt malfunction. Performing percutaneous transluminal angioplasty (PTA) for early shunt malfunction led to a reduction in the reconstruction of the shunt because of shunt stenosis. We plan to continue these activities for the early detection and management of shunt-related problems.