{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:55:23Z","timestamp":1791618923779,"version":"4.3.4"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009367","name":"Mansoura University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009367","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Problem statement<\/jats:title>\n                    <jats:p>Vascular Access (VA) in hemodialysis (HD) patients is vital for treatment efficiency and is influenced by Egypt\u2019s healthcare system and socioeconomic factors. It is a complex issue, shaped by both challenges and opportunities within the nation\u2019s healthcare infrastructure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine trends in VA use and associated characteristics in patients on HD based on data from a nationwide survey in Egypt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study targeted patients on maintenance hemodialysis across Egypt, using stratified cluster sampling from 11 representative governorates. Medical personnel collected data using a structured electronic Google Form questionnaire, which gathered data on patient demographics, clinical details, VA creation and complications, and healthcare access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 3,582 chronic HD patients. Data were collected over a one-year period from May 2023 to May 2024. An arteriovenous fistula (AVF) was the initial VA for 669 patients (18.7%), while a temporary catheter was used as the initial access in 2,861 patients (79.9%). AVF thrombosis was the primary cause of AVF failure, occurring in 69.7% of cases. Pre-HD VA creation was associated with substantially better fistula maturation, fewer VA numbers, and lower VA-related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Significant regional and sociodemographic variations in VA practices were observed across Egypt. The findings revealed persistent reliance on temporary catheters at HD initiation, with encouraging but limited progress in pre-HD AVF planning. These trends underscore the need for early referral strategies and targeted interventions to optimize vascular access outcomes nationwide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12882-025-04296-9","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T04:33:10Z","timestamp":1751949190000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt"],"prefix":"10.1186","volume":"26","author":[{"given":"Eman","family":"Nagy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karem","family":"Salem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Abdelsalam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha","family":"Shemies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehal","family":"Elshabrawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Abd Elwahab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Sabry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa A.","family":"Elsawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Albeyaly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Eleraky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"Mahmoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elsayed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayel","family":"Zaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Noureldin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Megahed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Foula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basma","family":"Sultan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Hamed","family":"Brawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walaa H.","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alshaimaa S.","family":"Mubarak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bishoy","family":"Tanagho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aber-Halim","family":"Attallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Ellawag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem Abo","family":"Shousha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5828-3758","authenticated-orcid":false,"given":"Emad","family":"Samaan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"4296_CR1","doi-asserted-by":"crossref","unstructured":"Farag YMK, El-Sayed E. 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Am J Kidney Dis. 2013;61(1):112\u201322.","journal-title":"Am J Kidney Dis"}],"container-title":["BMC Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-025-04296-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12882-025-04296-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-025-04296-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T04:33:19Z","timestamp":1751949199000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnephrol.biomedcentral.com\/articles\/10.1186\/s12882-025-04296-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4296"],"URL":"https:\/\/doi.org\/10.1186\/s12882-025-04296-9","relation":{},"ISSN":["1471-2369"],"issn-type":[{"value":"1471-2369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,8]]},"assertion":[{"value":"9 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This questionnaire-based, non-interventional study was conducted in accordance with the regulations of Egyptian universities and the Ministry of Health, which require ethical approval from the Institutional Review Board (IRB) of the principal investigator\u2019s affiliated university. Ethical approval was obtained from the Mansoura University Faculty of Medicine IRB under approval number R.22.10.1913.R1. Additionally, administrative approvals were secured from the dialysis units involved in the study, with representatives from each center facilitating data collection and coordination. The participating centers included those from Dakahlia Governorate, Mansoura International Hospital, along with Sherbin, Nabarouh, Elgamalia, Elmataria, Shabrahour, Aga, Bilqas, Dekernes, Menyet El Nasr, Temai El Amdid, Elshawami, Elmanzalah, Talkha, Tanah, Mitghamar, Elsinbillawin, and Damas, with oversight by the Head of Dakahlia Nephrology Units. From Alexandria Governorate, approvals were obtained from Alexandria University Hospital, Alexandria Faculty of Medicine, Qabbary Specialized Hospital, and Al-Amerya General Hospital, with Alexandria University providing an additional IRB approval (IRB number 0306136). Participating centers from other governorates included Aswan University Hospitals, Aswan Faculty of Medicine, Aswan; Internal Medicine Department, Sohag Faculty of Medicine, Sohag; Internal Medicine Department, Port Said Faculty of Medicine, Port Said; Internal Medicine Department, Suez Canal Faculty of Medicine, Ismailia; Hemodialysis Unit, Obour Health Insurance Hospital, Kafr El-Sheikh; Internal Medicine Department, Assiut Faculty of Medicine, Assiut; Saint Mark Kidney Center, Cairo; Internal Medicine Department, Ain Shams Faculty of Medicine, Cairo; Al-Fayoum General Hospital, National Health Service, Al-Fayoum; and Internal Medicine Department, Al-Fayoum Faculty of Medicine, Al-Fayoum. The National Health Service dialysis units do not have independent IRBs and were represented by administrative approval from their respective directors. The last author, serving as the Director of Nephrology Administration in the Egyptian Ministry of Health, further ensured compliance with national regulatory standards. Informed consent was obtained from all participants, and no names or identifying patient data were collected, ensuring full privacy and confidentiality. This study was conducted in accordance with relevant ethical guidelines and regulations, as required by Egyptian universities and the Ministry of Health.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"361"}}