ArticleJornal vascular brasileiro2025
Strategy and cost analysis of vascular access for hemodialysis in North Macedonia.
Article in Jornal vascular brasileiro, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Artificial Intelligence and Sensing Technologies for Vascular Access in Hemodialysis: A Narrative Review.Sensors (Basel, Switzerland) · 2026Review
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Vascular access (VA) is a critical component of hemodialysis (HD). Arteriovenous fistulas (AVFs) are associated with lower morbidity and mortality compared to central venous catheters (CVCs). However, VA practice varies across different healthcare systems. Objectives: The aim of our study was to evaluate the trends, costs, and distribution of VA types used in North Macedonia over two decades. Methods: This retrospective study reviewed VA procedures performed at the University Clinic of Nephrology in Skopje from 2002 to 2023, highlighting trends and financial implications. Data on AVFs, tunneled central catheters (TCCs), and temporary catheters were collected and analyzed. Preoperative Doppler ultrasound assessments and follow-up evaluations were used to monitor AVF maturation and CVC placement. The cost analysis was based on the Diagnostic-Related Group coding system. Results: A total of 25 532 VA procedures were performed, including 5798 AVFs (83% of permanent VA), 1199 TCCs (17%), and 18 535 temporary CVCs. The number of AVFs steadily increased during the whole of the analyzed period, except in 2020 due to the COVID-19 pandemic. Temporary femoral vein catheterization accounted for 90% of CVCs. The financial burden of VA increased from 6.6% of the clinic's budget in 2018 to 9.3% in 2022, with a notable rise in CVC-related expenses. Conclusions: In North Macedonia, use of temporary CVCs at dialysis initiation remains high. Increasing the number of preemptive AVFs and improving long-term VA planning are essential to optimize patient outcomes and reduce healthcare costs.
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