Hemodialysis treatment (HD) is the most common form of renal replacement therapy in patients with end-stage renal disease (ESRD). The quantification of the dialysis dose is an essential element in the treatment of patients on chronic dialysis as it has a major impact on morbidity, mortality and quality of life. Optimal blood flow ≥300 mL/min—respectively, effective vascular access—has been found to provide both an adequate dialysis dose and is associated with a lower complication rate, lower annual hospitalizations, lower morbidity, and lower mortality. At the Clinic of Nephrology and Dialysis at St. Marina University Hospital in Varna, we researched and demonstrated the effect of the type of permanent vascular access on the dialysis dose received and the quality of life achieved, and we discovered that patients with native AVF get more effective treatment the higher the dialysis dose received, with better control of anemic syndrome, significantly lower frequency of annual hospitalizations, and lower lethality.
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