[Integral management of vascular access by nephrologist. Three years work outcome].

Delay in perform the arteriovenous fistula (AVF) to begin haemodialysis is a major problem in the renal units in our country. Two nephrologists initiated, to solve this problem in its own hospital, to perform AVF from December 2001 to December 31st, 2004. Results were compared to surgical service which performed AVF until December 2001. Reduction in surgical waiting time to perform AVF and percent of patients without AVF at time of initiate haemodialysis treatment are the main results in nephrologists group. No technical differences are found between both groups. These differences come from integral management of AVF, with own and programmed surgical theatre, managed in the office, individualized the patients requirements, and a major surgical flux managed by nephrologists. We conclude that hospitals with a program similar to us with integral approach of AVF and vascular access coordinator, the vascular access could be managed in an efficacy way.