ABSTRACT
Mortality and morbidity rates in patients on haemodialysis vary among different countries widely due to variation in vascular access practices. Documented evidence of patterns and practices of various vascular access modalities in our population is scarce to allow for development of local guidelines or formulating steps to encourage adoption of international guidelines in Pakistani healthcare setup. To assess Vascular Access practices for haemodialysis patients in five dialysis facilities of Northern Pakistan. Cross sectional study. This study was carried out at five dialysis facilities in three cities of Northern Pakistan over a period of one year from March 2011 to March 2012. This cross sectional survey was completed by interviewing 536 end stage renal disease patients between 18 to 70 years of age over a period of one year. Duration of dialysis, types of access, current state and past history of vascular access were recorded and compared with International guidelines. Commonest 'current vascular access' was found to be AV fistula in 317 out of 536 patients [almost 60%] and the most common mode of 'first Vascular Access' [i.e. vascular access first used for haemodialysis] was catheter [83%]. Amongst patients who had dialysis during last eight months, 76.27% were still being dialysed via percutaneous catheters while this figure is less than 34% in Europe. Although the initial mode of dialysis in most cases is a line yet, majority of patients are dialyzed through native fistula. Need for a pre-emptive fistula is required to have superior longevity and fewer complications in haemodialysis patients