Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt

Abstract Problem statement Vascular Access (VA) in hemodialysis (HD) patients is vital for treatment efficiency and is influenced by Egypt’s healthcare system and socioeconomic factors. It is a complex issue, shaped by both challenges and opportunities within the nation’s healthcare infrastructure....

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Main Authors: Eman Nagy, Karem Salem, Mostafa Abdelsalam, Rasha Shemies, Nehal Elshabrawy, Ahmed M. Abd Elwahab, Alaa Sabry, Alaa A. Elsawi, Ahmed Albeyaly, Hamed Eleraky, Hala Mahmoud, Mohamed Elsayed, Nayel Zaki, Ahmed Noureldin, Ahmed Megahed, Hassan Foula, Basma Sultan, Mohamed Hamed Brawy, Walaa H. Ibrahim, Alshaimaa S. Mubarak, Bishoy Tanagho, Aber-Halim Attallah, Mohamed Ellawag, Hazem Abo Shousha, Emad Samaan
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-04296-9
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author Eman Nagy
Karem Salem
Mostafa Abdelsalam
Rasha Shemies
Nehal Elshabrawy
Ahmed M. Abd Elwahab
Alaa Sabry
Alaa A. Elsawi
Ahmed Albeyaly
Hamed Eleraky
Hala Mahmoud
Mohamed Elsayed
Nayel Zaki
Ahmed Noureldin
Ahmed Megahed
Hassan Foula
Basma Sultan
Mohamed Hamed Brawy
Walaa H. Ibrahim
Alshaimaa S. Mubarak
Bishoy Tanagho
Aber-Halim Attallah
Mohamed Ellawag
Hazem Abo Shousha
Emad Samaan
author_facet Eman Nagy
Karem Salem
Mostafa Abdelsalam
Rasha Shemies
Nehal Elshabrawy
Ahmed M. Abd Elwahab
Alaa Sabry
Alaa A. Elsawi
Ahmed Albeyaly
Hamed Eleraky
Hala Mahmoud
Mohamed Elsayed
Nayel Zaki
Ahmed Noureldin
Ahmed Megahed
Hassan Foula
Basma Sultan
Mohamed Hamed Brawy
Walaa H. Ibrahim
Alshaimaa S. Mubarak
Bishoy Tanagho
Aber-Halim Attallah
Mohamed Ellawag
Hazem Abo Shousha
Emad Samaan
author_sort Eman Nagy
collection DOAJ
description Abstract Problem statement Vascular Access (VA) in hemodialysis (HD) patients is vital for treatment efficiency and is influenced by Egypt’s healthcare system and socioeconomic factors. It is a complex issue, shaped by both challenges and opportunities within the nation’s healthcare infrastructure. Aim To examine trends in VA use and associated characteristics in patients on HD based on data from a nationwide survey in Egypt. Methods This cross-sectional study targeted patients on maintenance hemodialysis across Egypt, using stratified cluster sampling from 11 representative governorates. Medical personnel collected data using a structured electronic Google Form questionnaire, which gathered data on patient demographics, clinical details, VA creation and complications, and healthcare access. Results The study included 3,582 chronic HD patients. Data were collected over a one-year period from May 2023 to May 2024. An arteriovenous fistula (AVF) was the initial VA for 669 patients (18.7%), while a temporary catheter was used as the initial access in 2,861 patients (79.9%). AVF thrombosis was the primary cause of AVF failure, occurring in 69.7% of cases. Pre-HD VA creation was associated with substantially better fistula maturation, fewer VA numbers, and lower VA-related complications. Conclusion Significant regional and sociodemographic variations in VA practices were observed across Egypt. The findings revealed persistent reliance on temporary catheters at HD initiation, with encouraging but limited progress in pre-HD AVF planning. These trends underscore the need for early referral strategies and targeted interventions to optimize vascular access outcomes nationwide.
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spelling doaj-art-7b84d4b1ba6b4eecbdbbcb64b94ead9f2025-08-20T04:01:52ZengBMCBMC Nephrology1471-23692025-07-012611910.1186/s12882-025-04296-9Trends in vascular access among patients on hemodialysis; a nationwide survey from EgyptEman Nagy0Karem Salem1Mostafa Abdelsalam2Rasha Shemies3Nehal Elshabrawy4Ahmed M. Abd Elwahab5Alaa Sabry6Alaa A. Elsawi7Ahmed Albeyaly8Hamed Eleraky9Hala Mahmoud10Mohamed Elsayed11Nayel Zaki12Ahmed Noureldin13Ahmed Megahed14Hassan Foula15Basma Sultan16Mohamed Hamed Brawy17Walaa H. Ibrahim18Alshaimaa S. Mubarak19Bishoy Tanagho20Aber-Halim Attallah21Mohamed Ellawag22Hazem Abo Shousha23Emad Samaan24Mansoura Nephrology and Dialysis Unit, Mansoura Faculty of MedicineInternal Medicine Department, Al-Fayoum Faculty of MedicineMansoura Nephrology and Dialysis Unit, Mansoura Faculty of MedicineMansoura Nephrology and Dialysis Unit, Mansoura Faculty of MedicineMansoura Nephrology and Dialysis Unit, Mansoura Faculty of MedicineMansoura Nephrology and Dialysis Unit, Mansoura Faculty of MedicineMansoura Nephrology and Dialysis Unit, Mansoura Faculty of MedicineMansoura Nephrology and Dialysis Unit, Mansoura Faculty of MedicineDakahlia Health Directorate for Hemodialysis Units, National Health ServiceMansoura International Hospital, National Health ServiceAswan Faculty of Medicine, Aswan University HospitalsAlexandria Faculty of Medicine, Alexandria University HospitalInternal Medicine Department, Sohag Faculty of MedicineInternal Medicine Department, Sohag Faculty of MedicineInternal Medicine Department, Portsaid Faculty of MedicineNephrology Department, Qabbary Specialized HospitalInternal Medicine Department, Suez Canal faculty of MedicineHemodialysis Unit, Obour Health Insurance HospitalInternal Medicine Department, Assiut faculty of MedicineInternal Medicine Department, Assiut faculty of MedicineSaint Mark Kidney CenterInternal Medicine Department, Ain Shams Faculty of MedicineAl-Fayoum General Hospital, National Health ServiceAl-Amerya General HospitalMansoura Nephrology and Dialysis Unit, Mansoura Faculty of MedicineAbstract Problem statement Vascular Access (VA) in hemodialysis (HD) patients is vital for treatment efficiency and is influenced by Egypt’s healthcare system and socioeconomic factors. It is a complex issue, shaped by both challenges and opportunities within the nation’s healthcare infrastructure. Aim To examine trends in VA use and associated characteristics in patients on HD based on data from a nationwide survey in Egypt. Methods This cross-sectional study targeted patients on maintenance hemodialysis across Egypt, using stratified cluster sampling from 11 representative governorates. Medical personnel collected data using a structured electronic Google Form questionnaire, which gathered data on patient demographics, clinical details, VA creation and complications, and healthcare access. Results The study included 3,582 chronic HD patients. Data were collected over a one-year period from May 2023 to May 2024. An arteriovenous fistula (AVF) was the initial VA for 669 patients (18.7%), while a temporary catheter was used as the initial access in 2,861 patients (79.9%). AVF thrombosis was the primary cause of AVF failure, occurring in 69.7% of cases. Pre-HD VA creation was associated with substantially better fistula maturation, fewer VA numbers, and lower VA-related complications. Conclusion Significant regional and sociodemographic variations in VA practices were observed across Egypt. The findings revealed persistent reliance on temporary catheters at HD initiation, with encouraging but limited progress in pre-HD AVF planning. These trends underscore the need for early referral strategies and targeted interventions to optimize vascular access outcomes nationwide.https://doi.org/10.1186/s12882-025-04296-9Arteriovenous fistulaHemodialysisTunneled linesNon-tunneled lines
spellingShingle Eman Nagy
Karem Salem
Mostafa Abdelsalam
Rasha Shemies
Nehal Elshabrawy
Ahmed M. Abd Elwahab
Alaa Sabry
Alaa A. Elsawi
Ahmed Albeyaly
Hamed Eleraky
Hala Mahmoud
Mohamed Elsayed
Nayel Zaki
Ahmed Noureldin
Ahmed Megahed
Hassan Foula
Basma Sultan
Mohamed Hamed Brawy
Walaa H. Ibrahim
Alshaimaa S. Mubarak
Bishoy Tanagho
Aber-Halim Attallah
Mohamed Ellawag
Hazem Abo Shousha
Emad Samaan
Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt
BMC Nephrology
Arteriovenous fistula
Hemodialysis
Tunneled lines
Non-tunneled lines
title Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt
title_full Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt
title_fullStr Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt
title_full_unstemmed Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt
title_short Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt
title_sort trends in vascular access among patients on hemodialysis a nationwide survey from egypt
topic Arteriovenous fistula
Hemodialysis
Tunneled lines
Non-tunneled lines
url https://doi.org/10.1186/s12882-025-04296-9
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