What is…?

End Stage Renal Disease
Chronic Kidney Disease, or CKD, is a progressive disease. When CKD gets worse, it can lead to kidney failure, called End Stage Renal Disease (ESRD).

Hemodialysis
Hemodialysis is a method for removing waste products from the blood when the kidneys are in renal failure. Routine hemodialysis is done in a dialysis outpatient facility, either within a hospital or a dedicated, stand alone clinic. Hemodialysis can also be done at home. Dialysis treatments in a clinic are initiated and managed by specialized staff made up of nurses and technicians.

Vascular Access
Vascular access is a pathway to a patient's bloodstream that allows hemodialysis to occur. In hemodialysis, three primary methods are used to gain access to the blood: an intravenous catheter, an arteriovenous (AV) fistula, or a synthetic graft. The type of access is influenced by factors such as the expected time course of a patient's renal failure and the condition of his or her vasculature. Patients may have multiple accesses, usually because an AV fistula or graft is maturing and a catheter is still being used.

What is the importance of prompt, effective vascular access care?

For the patient, the biggest benefit will be the longevity of their vascular access, thus being able to continue receiving hemodialysis treatment. It will also mean less hospital visits for vascular access complications and an overall improved quality of life.

For the nephrologist, it means added control over the continuum of care for vascular accesses. The continued evaluation of patients and their access allows for early intervention measures in contributing to the longevity of the vascular access. The emphasis on prompt diagnosis and treatment of vascular access complications allows more management in the care that dialysis patients receive from their dialysis facility. 

List of Procedures

Angiogram
Used as a diagnostic aid to visualize blood vessels. A contrast medium is injected and x-rays taken to identify and accurately assess blood vessels.

Angioplasty
A vascular access procedure that reopens narrowed or obstructed blood vessels to restore blood flow. The blocked vessel is usually opened by balloon dilation.

Thrombolysis (declot)
Anticoagulant agents are injected into the graft or fistula to dissolve the blood clot at the site of blood flow obstruction.

Permcath Procedures
Insertion of a catheter into a large vein (the most commonly used are the internal jugular vein or the femoral vein) for long term vascular access. Catheter Removal and Catheter Exchange procedures are also performed.

Temporary Catheter
The placement of a catheter into a large vein for a short term vascular access until a permanent access is placed and functioning.