Quality of hemodialysis access. The perspective of vascular surgeons

Background: The care of terminal kidney insufficiency patients with a functioning vascular access is the foundation to enable long-term survival of the patient by hemodialysis. The quality of the vascular access and the associated processes essentially determine the extent of the quality of life of dialysis patients and the costs associated with the treatment. Objective: This article presents examples of measures for increasing the quality of the structure, procedure and results surrounding the vascular access with respect to the importance in an interdisciplinary treatment concept for dialysis patients. Material and methods: Possible measures and concepts were analyzed based on the literature and on national initiatives on quality assurance and improvement. Results and discussion: The formation of certified centers represents a possibility to implement measures for improvement of the quality of hemodialysis access. Vascular surgical aspects of the placement and maintenance of a dialysis shunt play a core role in the safeguarding of high standards of quality. Therefore, this competence should be promoted by targeted advanced training concepts, especially from the side of vascular surgery.