Despite its many benefits, peritoneal dialysis (PD) uptake is quite poor in many countries. For example, in Malaysia, around 12% of all patients with end stage kidney disease (ESKD) are on PD). One barrier to use of this…
Clinical Scenario 1: Mr.T is a 68 year old male with long standing uncontrolled Type 2 diabetes mellitus complicated by diabetic retinopathy and neuropathy. Over the years he has had progression of chronic kidney disease with subnephrotic range…
Last week we covered 5 clinical scenarios involving arteriovenous fistula and graft complications. We now discuss another 5 common scenarios as part 2 of the series. Please note: these cases are vignettes created for educational purposes and patient…
We learn the concept of ‘Fistula First’ since day 1 of fellowship. However primary failure rates have been rather high, with variable numbers reported in different literature. In addition, other complications related to AV fistula and AV graft…
Introduction The surgical technique for creating an arteriovenous fistula (AVF) has existed since 1966. AVFs are the recommended vascular access for end stage kidney disease patients who require dialysis, but only 14% of patients in the United States…
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….
Interventional nephrology is quickly becoming a sought after “subspecialty” of nephrology. However, many training programs do not offer a structured training program (as highlighted in this recent AJKD paper). Traditionally nephrology training is spent rounding in the hospital,…
