<b><i>Background/Aims:</i></b> Vascular access (VA) is the highest risk factor for blood infections, hospitalization, and mortality of patients undergoing hemodialysis (HD). The risk of mortality while using a catheter is greater than that while using grafts. The objective of this article is to know the survival rate in relation to the type of VA. <b><i>Methods:</i></b> A retrospective cohort of HD patients was studied. The data gathered included age, gender, first VA at the surrogate site, days between the first and second access, number of accesses, and anatomical site of VA placement. Mean differences were estimated using χ² or Student’s <i>t</i> test. Survival was calculated using the Kaplan-Meier curves and included in tables. Statistical significance was established as <i>p</i> &#x3c; 0.05. The statistical computer software package SPSSw v25 was used for the analysis. <b><i>Results:</i></b> A total of 896 patients were included with a mean age of 47.88 years (SD ± 16.52), the duration of the first VA was 398.81 days (±565.79), the mean number of VAs used was 2.26 (±1.15), and the median time undergoing HD was 728.73 days. The duration of catheter placement was 330.42 days, and 728.60 days for fistula use (<i>p</i> = 0.001). The mean number of days of renal replacement was 611.59 days for catheter and 1,495.25 days for internal arteriovenous fistula (IAVF) patients (<i>p</i> = 0.001). <b><i>Conclusions:</i></b> The survival of the initial VA is greater for the IAVF, followed by the tunneled catheters and the lowest by the non-tunneled catheters, which continue to be frequently used in our setting.

<b><i>Introduction:</i></b> For the majority of renal replacement therapy history, the main treatment option for patients with end-stage renal disease (ESRD) in Mexico has been peritoneal dialysis. However, the use of hemodialysis is overwhelmingly increasing, driving public health care institutions to subrogate this service. Even when the actual hiring model for subrogation is accurate, there is a lack of quality control points in the hemodialysis prescription, poor adherence to clinical practice guidelines, and a few or no record of outcomes in hemodialysis patients of these subrogated services. The objective of this work is to fill this information gap to allow for uniform and safe hemodialysis for patients of Mexico. <b><i>Material and Methods:</i></b> An observational and cross-sectional study was performed, including all patients receiving chronic hemodialysis treatment in subrogated units of Mexican Social Security Institute (IMSS) in the northern region of Mexico City. Clinical and biochemical data as well as hemodialysis dose by Kt/V and urea reduction rate were collected and evaluated. To determine distribution, mean or median and SD or interquartile range were used; for nominal variables, the difference in proportions was estimated using the χ² test; proportions were analyzed for biochemical values using the statistical package SPSS version 25. <b><i>Results:</i></b> In our study, &#x3e;60% (485) of the patients were anemic with an average hemoglobin of 9.39 mg/dL (SD ± 1.83); serum calcium was found below 8.4 mg/dL in 51.3% (383) of patients, and only in 45.8% (342) was at an optimal level of this parameter. Only 33.5% of patients have arteriovenous fistula for dialysis access. The hemodialysis dose was optimal in &#x3e;75% of patients. <b><i>Conclusions:</i></b> It is necessary to enhance and monitor treatment of comorbidities in patients with ESRD in subrogated hemodialysis units in México. We observed adequate prescription of hemodialysis in a majority of patients, achieving quality control points for removal of nitrogen products. Yet, there is a lack of quality control of comorbidities; therefore, we should aim to optimize treatment for mineral-bone disorder, anemia, and nutritional status.

Introducción y objetivo La epidemia de SARS-CoV-2 representa un riesgo especial para los pacientes en hemodiálisis (HD) por sus comorbilidades, y el cursar con una inflamación más severa con menos síntomas y peor evolución. Nuestro objetivo fue conocer las características clínicas y bioquímicas de los pacientes en hemodiálisis (HD) que presentaron cuadro sospechoso de COVID-19 (por sus siglas en inglés de Corona Virus Disease – 2019), sus factores de riesgo y desenlace. Material y métodos Estudio de reporte de casos, retrospectivo, observacional, en los pacientes en HD sospechosos de COVID-19. Registrándose comorbilidades, clínica, laboratorio, prueba de transcripción reversa cuantitativa de la reacción en cadena de polimerasa (RT-qPCR) para SARS-COV-2 y desenlace. Se realizó estadística descriptiva y análisis de regresión lineal y logístico. Resultados De 1.514 personas que recibían tratamiento de HD, 248 pacientes presentaron sintomatología sospechosa de COVID-19 (106 positivos, 83 negativos y 59 sospechosos por PCR), mediana de edad de 51 años (RI 36-63 años), 54,8% masculinos, hipertensión (87,5%), hemoglobina de 8,9 g (RI 7,5-10,6 g); la sintomatología de tos, fiebre y disnea (65,7, 64,5 y 53,2% respectivamente). El porcentaje de letalidad en el grupo de los pacientes con RT-qPCR positiva fue de 29,24%. Conclusiones La tasa de mortalidad y letalidad es alta en este tipo de población. El grupo etario, el sexo y las comorbilidades cardiometabólicas se comportan similar al resto de la población no renal. El estado bioquímico preexistente no marca una diferencia en el desenlace. La sintomatología predominante es respiratoria.