title: Vascular access registry of Serbia: a 4-year experience.
abstract: OBJECTIVE
  Adequate and functional long-term vascular access (VA) is pivotal for the efficient hemodialysis (HD). It has been shown that the most reliable VA is autogenous arteriovenous fistulas (AVFs) as compared with arteriovenous grafts (AVGs) and vascular catheters (VCs). The vascular access register (VAR) has been established since 2010, and the 4-year trend of VA in Serbia is presented in this paper.
  
  
  METHODS
  All HD centers in Serbia provided their data by fulfilling the questionnaire that included prevalent and incident HD patients on December 31, 2010-1013.
  
  
  RESULTS
  AVF is the most frequent prevalent VA (89.5-93.1 %) and also the most frequent newly created VA (87-89 %) during the observational period. The number of preemptive AVF is increasing, but it is still low (7.8 % in 2010 and 14.6 % in 2013). The percentage of incident AVG is constant (~3.4 %) as well as the number of permanent VC (8.2 % in 2010 and 7.8 % in 2013). The number of incident patients who started HD with AVF is decreasing (from 37 to 27 %), and the number of urgent start with VC is on the increase (from 63 to 73 %). In almost all relevant dialysis centers, vascular access is created by surgeons. Temporal VCs are placed by anesthesiologists (all centers), nephrologists (up to 25 % of centers) and vascular surgeons (up to 20 %). VCs are located mainly in jugular vein, but the number of femoral catheters remains high (up to 69 %).
  
  
  CONCLUSIONS
  Although we have favorable data, the VAR is of a great importance and ensures continuous quality improvement.
authors.affiliation: School of Medicine, University of Belgrade, Belgrade, Serbia. tjemcov@gmail.com.|Department of Nephrology, Clinical Hospital Centre Zemun, Belgrade, Serbia. tjemcov@gmail.com.
authors.forename: Tamara
authors.initials: T
authors.lastname: Jemcov
authors.affiliation: School of Medicine, University of Belgrade, Belgrade, Serbia.|Department of Nephrology, Clinical Hospital Centre Zvezdara, Belgrade, Serbia.
authors.forename: Nada
authors.initials: N
authors.lastname: Dimkovic
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000379:methods / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000706:statistics & numerical data; D005260:Female; D005268:Femoral Vein / Q000601:surgery; D006801:Humans; D015994:Incidence; D007601:Jugular Veins / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology; D062666:Vascular Access Devices; D058017:Vascular Grafting / Q000379:methods / Q000706:statistics & numerical data
keywords: Hemodialysis; Serbia; Vascular access registry