{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:11:25Z","timestamp":1777936285619,"version":"3.51.4"},"reference-count":11,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Nicaragua is a Central American country with a high prevalence of patients with chronic kidney disease, particularly among young men. This is largely attributable to Mesoamerican nephropathy, a form of interstitial nephritis that predominantly affects young agricultural workers. While the majority of patients have access to chronic dialysis programs, a very small number have an option of receiving a renal transplant. Consequently, they must spend years on hemodialysis (HD), where the vascular access issue is of vital importance for their survival. Given that prosthetic arteriovenous grafts (AVG) are expensive devices with a lower cost-benefit ratio, limited availability within the health system and are unaffordable for the majority of patients, it is crucial to perform autogenic arteriovenous fistula (AVF) whenever possible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods:<\/jats:title>\n                    <jats:p>This paper presents a 4-year period review (2020\u20132023) of a single-center vascular access program that optimizes vasculature utilization of each patient for creation of AFV and describes the surgical revision techniques used to prolong the patency of vascular accesses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The autogenic vascular access program has resulted in more than 80% of prevalent patients undergoing HD at our center being hemodialyzed through an autogenic AVF by the end of 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>It can be concluded that it is possible to significantly increase the proportion of autogenic vascular accesses in each center by optimizing the patient\u2019s own vasculature. This approach has the potential to reduce morbidity and costs, particularly in low-income countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298241310621","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T02:22:26Z","timestamp":1737426146000},"page":"1931-1935","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Maximizing use of available vascular capital for autologous arteriovenous fistula creation and maintenance: Single center results"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6540-1240","authenticated-orcid":false,"given":"Alexis","family":"Garcia-Lopez","sequence":"first","affiliation":[{"name":"Baptist Hospital Hemodialysis Center, Managua, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leyla","family":"Abdalah","sequence":"additional","affiliation":[{"name":"Baptist Hospital Hemodialysis Center, Managua, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2784-5268","authenticated-orcid":false,"given":"Octavio J","family":"Salgado","sequence":"additional","affiliation":[{"name":"Department of Nephrology, School of Medicine, Universidad Catolica de Cuenca, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4494-966X","authenticated-orcid":false,"given":"Tushar J","family":"Vachharajani","sequence":"additional","affiliation":[{"name":"John D. Dingel VA Medical Center, Detroit, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"The World Bank. World Bank \u2013 income classifications https:\/\/datahelpdesk.worldbank.org\/knowledgebase\/articles\/906519-world-bank-country-and-lending-groups (2024 accessed July 2024)."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S270709"},{"key":"e_1_3_3_4_2","unstructured":"Pan American Health Organization. Epidemic of chronic kidney disease in agricultural communities in Central America. Final Report Board of directors No. 60. CD60\/INF\/8. Washington DC 25 July 2023. www.cd60-inf-8-e-chronic-kidney-disease-final-report-002 (accessed April 2024)."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000381"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000802"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000828"},{"key":"e_1_3_3_8_2","unstructured":"US Renal Data System. Annual Data Report 2023. End stage renal disease: chapter 4. Vascular access. https:\/\/usrds-adr.niddk.nih.gov\/2024\/end-stage-renal-disease\/4-vascular-access (accessed April 2024)."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.09.012"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.01.049"},{"key":"e_1_3_3_11_2","first-page":"58","article-title":"Recommendations for the creation, care, and management of vascular accesses for hemodialysis. Position Document of the Interventional Nephrology Committee and the consensus group for optimization of vascular accesses of the Latin American Society of Nephrology and Hypertension (SLANH)","volume":"18","author":"Arvizu-Hern\u00e1ndez M","year":"2021","unstructured":"Arvizu-Hern\u00e1ndez M, Salgado OJ, Arellano-Sotelo J, et al Recommendations for the creation, care, and management of vascular accesses for hemodialysis. Position Document of the Interventional Nephrology Committee and the consensus group for optimization of vascular accesses of the Latin American Society of Nephrology and Hypertension (SLANH). Neprol Latinoam 2021; 18: 58\u201370.","journal-title":"Neprol Latinoam"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2021.05.008"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241310621","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298241310621","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241310621","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:25:55Z","timestamp":1777692355000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298241310621"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,20]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1177\/11297298241310621"],"URL":"https:\/\/doi.org\/10.1177\/11297298241310621","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,20]]}}}