doiSerbia

High rate of native arteriovenous fistulas: How to reach this goal?

Jemcov Tamara (Clinical Center of Serbia, Clinic for Nephrology, Belgrade)
Milinković Marija (Clinical Center of Serbia, Clinic for Nephrology, Belgrade)
Končar Igor (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade + School of Medicine, Belgrade)
Kuzmanović Ilija (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade)
Jakovljević Nenad (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade)
Dragaš Marko (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade + School of Medicine, Belgrade)
Ilić Nikola (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade + School of Medicine, Belgrade)
Đorić Predrag (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade + School of Medicine, Belgrade)
Dimić Andreja (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade + School of Medicine, Belgrade)
Banzić Igor (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade)
Kravljača Milica (Clinical Center of Serbia, Clinic for Nephrology, Belgrade)
Nešić Vidosava (Clinical Center of Serbia, Clinic for Nephrology, Belgrade + School of Medicine, Belgrade)
Davidović Lazar (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade + School of Medicine, Belgrade)

The types of vascular accesses for hemodialysis (HD) include the native arteriovenous fistula (AVF), arteriovenous graft (AVG) and central venous catheter (CVC). Adequately matured native AVF is the best choice for HD patients and a high percentage of its presence is the goal of every nephrologist and vascular surgeon. This paper analyses the number and type of vascular accesses for HD performed over a 10-year period at the Clinical Center of Serbia, and presents the factors of importance for the creation of such a high number of successful native AVF (over 80%). Such a result is, inter alia, the consequence of the appointment of the Vascular Access Coordinator, whose task was to improve the quality of care of blood vessels in the predialysis period as well as of functional vascular accesses, and to promote the cooperation among different specialists within the field. Vascular access is the “lifeline” for HD patients. Thus, its successful planning, creation and monitoring of vascular access is a continuous process that requires the collaboration and cooperation of the patient, nephrologist, vascular surgeon, radiologist and medical personnel.

Keywords: arteriovenous fistula, hemodialysis, vascular access coordinator, Color Doppler ultrasonography, vascular access