Arteriovenous graft are the most frequent alternative to the arteriovenous fistula. Although arteriovenous grafts 'mature' fasterthan endogenous fistulas, at least 3 weeks are needed before the first puncture to allow endothelialization of the internal wall. Implantation of arteriovenous graft is foreign material, are subjected to a high risk of thrombotic and infectious complications.

Haemodialysis, as a drastic medical procedure, needs a modern technology for performing of qualitative depurative process. Trying to imitate a function of healthy kidneys, it provides survival without one vital organ. The aim of the study was a qualitative estimation by comparing laboratory and clinical parameters of one-year haemodialysis treatment with different dialysis methods. In all patients treated with chronicle haemodialysis in Dialysis Centre in Kosovaska Mitrovica, we performed a set of laboratory analyses, recorded hepatotrophic viruses and determined a quality of haemodialysis by the degree of urea elimination. There are 16 patients on chronicle haemodialysis, 11 female (68,75%) and 5 male (31,25); mean age, 52,46±16,89 years, mean time on dialysis was 58±51,835. An increase of hemoglobin concentration was correlated with bicarbonate heamodialysis initiation. (61,692±19,405 vs. 75.466±13,814; p=0,038). Cholesterol (5,32±1,522 vs. 4,34± 1,006; p=0,0481) and inorganic phosphorus (1,427±0,2327 vs. 1,692±0,260; p=0,0056) are biochemical factors that are in a reverse correlation with bicarbonate haemodialysis in our patients. The degree of urea elimination as a measure for haemodialysis adequacy was statistically significant indicator of an adequate dialysis and was correlated with bicarbonate haemodialysis initiation (t=8,571; df=1; p=0,0389)

The birthrate in Serbia has been falling and we are the last country in Europe according the number of newborn children. The aim of this study was to establish the birthrate trend during the period of five years on the territory of Central Kosovo and Metohija, according the data of Gynecology- Obstetrics Clinic/Gracanica, to indicate the importance of an improvement of women's health care, increase the birthrate and population growth rate. There was used a retrospective method of examination of the data from the maternity hospital register in Gracanica. There were also used the data from the death registry in the local community of Donja Gusterica and the records of students enrolled into the first grade of Primary School in Donja Gusterica. During the period from March 2002 to August 2005 there were born 1718 children (912 boys and 806 girls). There is almost no family on this territory with less than three children and there is a significant number of families with four or five children. The number of women who bore six times was 24, seven times was 13 and eight times was 11 while there were two women who born the ninth child and one woman who bore the eleventh child. During the five-year period, on the territory of local community of Donja Gusterica, there died 169 people while, at the same time, the number of students enrolled into the first grade of primary School was 293. An important contribution to growth of natality is an improvement of the women's health care. There was noticed a constant increase in number of newborn children for the mentioned period as well as a significant increase in population growth rate in Central Kosmet

Diabetes is the most common cause of end-stage renal disease .in United States , Europa and Japan. Approximately 40% of patients with type 1 diabetes and 5-15% of patients with type 2 diabetes eventually develop end-stage renal disease. Risk factors for development of diabetic nephropathy include hyperglycemia, hypertension, positive family history of nephropathy and hypertension, and smoking. Key elements in the primary care of diabetes include glycemic control, blood pressure control, and screening for microalbuminuria. In general, the goal for glycemic control is a blood glucose level as close to normal (HbA C <7%) . Blood pressure control is at least as important as glucose control, especially after the onset of 1 renal damage, and blood pressure should be consistently <130/85. Screening for diabetic nephropathy involves monitoring at least yearly for urinary albumin excretion >30 mg per day. Microalbuminuria is defined as the urinary excretion of 30300 mg of albumin per day. Both glycemic control and rigorous control of blood pressure have significant impact on prevention and progression of diabetic nephropathy. Identification of patients with microalbuminuria selects a population of patients with increased mortality. Microalbuminuria screening should begin at the time of diagnosis. ACE inhibitors should be used when microalbuminuria is present regardless of the presence or absence of hypertension in type 1 diabetes and are widely.
used in normotensive patients with type 2 diabetes, as well.The effect of ACE inhibitors is probably not only via lowered
systemic blood pressure but also via direct effects on intraglomerular hemodynamics. 

In this work we have examined echocardiographic characteristics of left ventricle in patients with acute myocardial infarction (AMI). We used prospective study, during 12 months, and we followed 55 patients with diagnosed non Q AMI. All patients were hospitalized in the Coronary unit. Results: 55 consecutive (40 males middle age 55,4±8,7 and 15 females middle age 57,4±10,3) had non Q AMI. Value of ejection fraction: after 4.day - 50,4±6,2% ,2.weeks - 54,6±5,8%, 4. weeks - 59,3±5,4%. Value of ejection fraction in patients with thrombolytic therapy: 61,6±6,8% vs. 57,3±6,6% p> 0,05;Value of left ventricle fractional shortening: 28,8±2,5% (in patients with thrombolytic therapy 30,3±4,8% vs.27,2±5,9%) Value of end2 2 2 - diastolic volume: after 4.day- 62,5±5,3 ml/m , 2.weeks - 63,1±5,4 ml/m , 4. weeks - 64,4±5,8 ml/m (in patients with throm 2 2 2 bolytic therapy 60,5±9,2 ml/m vs. 67,4±8,4 ml/m ) Value of endsistolic volume: after 4. day - 26,2±2,1 ml/m , 2.weeks2 2 26,8±2,3 ml/m , 4. weeks - 27,6±2,2 ml/m (in patients with thrombolytic therapy 25,6±2,8 ml/m2 vs. 31,7±3,1 ml/m2 p> 0,05). During the in-hospital follow up period, 2(3,6%) patients and during the post-hospital follow up period, 1 (1,9%) patients with non Q AMI had lethal outcome.

Pruritus is one of the commonest symptoms of dermatologic appearances in uraemic syndrome and it occurs in 90% of patients on dialysis with different etiology and pathophysiology. The aim of the study was to estimate the frequency of uraemic pruritus and the comparison with clinical and biochemical parameters in 124 patients treated by chronicle haemodialysis at Department of Haemodialysis, Urology and Nephrology Clinic, Clinical Center “Kragujevac”. The routine laboratory analyzes were carried out in examined patients and the concentration of parathyroid hormone was determined. The study was based on data from history of disease and  questionnaire carried out in all patients. Of 124 patients, 65,3% were male and 34,7% were female, mean age of 55,98±12,94 years; the mean time on HD was 55,5 ±50,4 months. 46,8% of examined patients had symptoms of uraemic pruritus. Uraemic syndrome and uraemic complications, manifested by the concentration of urea, 21,57±7,56 vs. 22,93±5,754; p=0,05 and time on dialysis, 67,27±60,07 vs. 43,64±36,84; p=0,02, are the significant parameters of uraemic pruritus. Serum concentration of iron 15,16±8,03 vs. 11,73±6,21; p=0,05 and UIBC 25,12±10,6 vs. 30,45±9,86; p=0,04, as well as hyperglycemia 6,16±2,516 vs. 6,82±2,872; p=0,02 are significantly correlated with uraemic pruritus. There was a statistically significant difference in albumin concentration 35,84±9,09 vs. 37,72± 3,105; p=0,05 but our results were reverse to the data in literature where the reported albumin level was higher in patients with uraemic pruritus. 27,6% of examined patients had itching of all the body what is in correlation with literature. Between the patients with localized itching and patients with generalized itching, there are statistical significance in following: number of erythrocytes 2,4±0,96 vs. 2,7±0,6; p=0,02, concentration of hemoglobin 78,53±31,44 vs. 89,36±19,81; p=0,05, hematocrit 0,23±0,089 vs. 0,26±0,057; p=0,02 and TIBC 29,45±12,01 vs. 34±4,86; p=0,02, as well as concentration of glycemia 5,38±2,52 vs. 6,42±2,12; p=0,01.

The retrospective study included all patients treated at Clinical Centre in Kragujevac, who needed an acute HD treatment due to vital endangerment, during 2003. The objective of this study was to demonstrate our experiences in treating these patients using central venous catheter. The results of this study show that femoral catheters are dominant (over 95%), with slight using of jugular and subclavial catheters (5%), in spite of the recommendation of the American Association for Renal Diseases to use femoral catheters only for patients supposed to be in hospital during the interval of 5 days. The
frequency of infections in our study (16,6%), coincides with the data of the American Association for Nosocomial Infections (NNIS)[1] (17,8% catheter infections). Gram-positive bacterium from Staphylococci group are the most frequent cause of catheter infections also in our patients

There are different reports regarding the characteristics of examined quality of life (QOL) in patients with combined coronary and valvular surgery. Objective was to compare the quality of life changes after isolated coronary and associated coronary and valvular surgery. From February to May 2002, we prospectively studied 243 consecutive patients, who underwent elective CABG. The Nottingham Health Profile Questionnaire part I (NHPpart I) was used as a model for QOL determination. NHPpart I contains 38 subjective statements divided into six sections: physical mobility (PM), social isolation (SI), emotional reaction (ER), energy (En), pain and sleep. The scores ranged from zero to 100, by adding the item weight, determined by Thurstone method of paired compares, to every positive answer. We distributed the questionnaire to all patients before and six months after CABG. Two hundred twenty six patients filled in the postoperative questionnaire. An isolated coronary heart disease was present in 218 patients (89.71%), and associated coronary and valvular disease in 25 patients (10.29%). Preoperatively, there is no difference in QOLamong the examined groups. After operation, quality of life was improved in 84.65% (171/202) of patients using coronary surgery and in 79.17% (19/24) of patients using combined (coronary and valvular) surgery. Quality of life was statistically improved in the first group of patients in all sections, and in the second group of patients in 4 sections (PM, En, pain and sleep) (p<0.05). There is no significant correlation between the quality of life changes after operation and the type of surgical procedure. By univariate and multivariate logistic regression, combined procedure distinguished as the independent predictor of QOL worsening in the ER section (p=0.012, OR=3.62, 95% CI 1.32-9.92). Six months after CABG quality of life was significant better in most of patients in both studied groups. Associated coronary and valvular surgical intervention distinguished as the independent predictor of quality of life worsening in the ER section.