Introduction Patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are frequently on anticoagulation (AC) due to their increased risk of stroke and thromboembolism, particularly from atrial fibrillation. Management of AC in kidney patients undergoing invasive…
Introduction Ideally, patients with end-stage kidney disease would begin hemodialysis with a mature, functional arteriovenous access. However, in certain subgroups of patients, central venous catheters (CVCs) are unavoidable. Even for patients who ultimately use an arteriovenous fistula (AVF)…
Last week we looked at the basics and useful terminology employed for examining a vascular access. Now we will focus on specifics of the physical exam. Physical Examination Inspection (Look) Visual inspection can provide important clues regarding the…
Introduction Physical examination is a quick and inexpensive way of diagnosing stenosis and other causes of vascular access dysfunction. Its ability to reliably detect stenotic lesions compared with ultrasound and angiography (the gold standard), has repeatedly been demonstrated….
An interventional nephrologist is a nephrologist who performs vascular access related procedures in hemodialysis (HD) patients. Dialysis vascular access remains the Achilles’ heel of hemodialysis. Despite the Fistula First Initiative, catheter dependence remains high among incident HD patients….
