Formation of vascular access in elderly and diabetic patients is burdened with many difficulties. The aim of this study was to determine the factors that older people and patients with diabetes mellitus defined as the population risk for the formation of arteriovenous fistula for hemodialysis. The study was organized as a retrospective study, a subject of interest in people older than 65 years of age and diabetes, which in four years because of the need for further treatment performed arteriovenous fistula. Analyzed the demographic structure of the patient, type of anastomosis, the use of central-venous catheters for hemodialysis, arterial blood pressure and size of the lumen of blood vessels used for anastomosis, intraoperative measured. From the laboratory analysis determined the routine hematological and biochemical parameters. In relation to the positioning of arteriovenous fistula (p=0.033), the placement of catheters for hemodialysis (p=0.0009), preventive form of vascular access (p=0.04) and values of systolic (p=0.0001) and diastolic (p=0.0001) arterial blood pressure, achieved a statistically significant difference. Patients with diabetic nephropathy, compared to the population of elderly, have a significantly higher number of leukocytes (7.5±2.61 vs. 8.5±3.24, p=0.03), fibrinogen level (5.57±2.39 vs. 6.8±1.71, p=0.036), glycemia (5.35±1.24 vs. 7.1±2.28, p<0.0001), cholesterol (3.77±1 , 03 vs. 4.5±1.71, p=0.001), triglycerides (1.59 ±0.62 vs. 1.86±0.76, p=0.009) and LDL-cholesterol (2.13±0.76 vs. 2.42±2.04, p=0.02). Total proteins (64±9.98 vs. 62 ±7.4, p=0.027) and albumin (36±34 vs. 9.55±5.49, p=0.037) were significantly lower values in diabetics. Characteristics of older diabetics and is characterized as a risk population of patients for the creation of arterio-fistula were timely creation and position of arterio fistula, the need for placement of central-venous catheters for hemodialysis and arterial blood pressure.

Doppler ultrasound check-up significantly increases a possibility of initial functioning of arteriovenous fistula. The aim of the study was the preoperative evaluation of vascular system of the extremity for creation of arteriovenous fistula for haemodialysis. The examination was organized at Urology and Nephrology Clinic, Clinical Centre "Kragujevac". The examined subjects were 87 patients, 52 (59,8%) male and 35 (40,2%) female, mean age of 61±11,1 years. There were performed the routine biochemical analyses, demographical structure and clinical characteristics (type of anastomosis, fistula placement, arterial blood pressure, lumen size of the artery and vein, measured intraoperatively by Doppler technique). In 72,1% of patients with functioning fistula there was made a terminal-lateral anastomosis, compared to 57,7% of patients with initial non-functioning fistula, there was found a statistically significant difference between the groups p=0,008. Radiocephalic fistula was created in 62,3% of the examined patients with initial functioning , in patients with non-functioning, the distal fistula was created in 38,5% of the examined patients. Regarding the type of the fistula location there was obtained statistically significant difference; p=0,04. There was found a statistically significant difference between the group of patients with initial functioning of arteriovenous and the group without, concerning the intraoperatively measured lumen of the cephalic vein (2±0,29 vs. 2±0,38 mm); p=0,03 (2,1±0,5 vs. 1,8±0,4); p=0,0009. Statistical significance between the groups was also found in the lumen of the cephalic vein verified by the ultrasound (2,1±0,53 vs. 1,8±0,25 mm); p=0,038. Peak of the systolic speed of the radial, corelated to the group of patients with and the group without initial functioning fistula (50 ± 12,42 vs. 40 ± 6,9 cm/sec); (p=0,0026), has statistically significant value. By the correlation of the group of patients with initial functioning and the group of patients without initial functioning, regarding hemoglobin (97 ± 16,1 vs. 88 ± 18,3 g/l); p=0,006 and the level of urea (22,6 ± 12,7 vs. 23,9 ± 9,8); p=0,02, there was found a statistically significant difference. Color Doppler ultrasound has an important role in preoperative evaluation of blood vessels and it represents a meaningful predictive parameter of functioning of arteriovenous fistula. 

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

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