Vascular access for haemodialysis--role of the urologist.

Twelve years urological experience at the Klinikum Potsdam with subcutaneous arteriovenous anastomosis as a vascular access for chronic haemodialysis is described. More than 774 access operations have been performed, 344 of them on 255 patients in the last 3 years. The side-to-end anastomosis between radial artery and cephalic vein in the lower arm has proved to be the method of choice. In 187 of the 255 patients (73%) the first operation was successful. Of the other 68, more than 157 operations were necessary for successful vascular access in 55 patients. To summarize, in 242 out of 255 patients (95%) a functioning vascular access was achieved after 1.4 operations per patient. In only 13 patients was it necessary to implant a heterologous vascular graft. In our opinion, the urologist should contribute to the success of treatment for end-stage-renal-disease.