Influence of Surgeons’ Specialty on the Selection of Vascular Access for Hemodialysis Treatment

Background/Aim: Various patient-related factors could not explain the variability of access types across facilities in the published literature. The aim of this study was to investigate the influence of surgeons’ specialty on access type selection for hemodialysis treatment. Methods: The directors (nephrologists) of all renal units in Greece (n = 92) were surveyed by a closed questionnaire. Results: The response rate was 75%. There was no statistically significant difference in the percentage of patients predominantly with autologous arteriovenous fistulae between units where only vascular surgeons were performing access surgery and those where either general surgeons or transplant surgeons were operating (mean value in all renal units 80.8% , range 43–97%). However, the difference between the three groups of renal units regarding their surgeons’ ability to create complex access procedures and to correct complications (as an index of surgeons’ skill) was statistically significant (p < 0.001). Conclusion: The general surgeons of the new generation are not often using vascular surgical techniques and may have less opportunities to develop expertise in vascular access creation.