Evolution of vascular access for hemodialysis in the Dialysis Unit of the Hospital General Docente de Calderón (Quito, Ecuador) during the period between October 2021 and January2023

Introduction: chronic kidney disease is the fourth leading cause of death in Ecuador. Despite this, there are epidemiological data published in the country on vascular access that facilitate the implementation of health strategies that improve the quality of renal replacement therapy or that allow a comparative analysis with other dialysis centers. Objective: to determine the evolution of the type of vascular access used in patients in the dialysis unit of Hospital General Docente de Calder & oacute;n (HGDC), in Quito (Ecuador). Methods: retrospective observational study, which gathered data on patients who were admitted to renal replacement therapy in the dialysis unit registered in the computer system during the period October 2021 to January 2023. Results: a total of 128 patients were admitted to the dialysis unit, with an average age of 54 years, more frequent vascular access at the start of renal replacement therapy (RRT) was central venous catheter (CVC, 87.8 %) and fistulas (12.2 %), evidencing during the established period of time a high percentage of conversion from CVC to fistulas from 12.2 % in 2021 to 51.2 % in 2023. Conclusions: this percentage follows the recommendations of international guidelines where arteriovenous fistula is prioritized over central venous catheters as the first vascular access in renal replacement therapy.