Vascular Access: The Point of View of a Young Nephrologist

Abstract

The new millennium's scenario is more complex than in the past. Patients are older and more critical than 30 years ago; therefore, I suggest a different approach: taking advantage of the new protagonists of our field to improve our practice. It becomes thus necessary a close collaboration with all relevant colleagues, among whom: • experienced nephrologists that believe in us, in our potential, and in our preparation • radiologists and anesthesiologists eager to pursue a continuous education • surgeons for the decision of the kind of vascular access: arteriovenous fistula (AVF), native or prosthetic, distal or proximal. I believe that nephrologists can create an AVF, since they have a working knowledge of AVF's use in hemodialysis patients. However, the best choice is still the complete collaboration with surgeons that are available to share their technical experience with young nephrologists. Moreover, it would be ideal to establish an effective collaboration for the preparation of prosthetic AVFs for which surgical skills are fundamental.