Endovascular Techniques for Dialysis Vascular Access

Abstract

A nephrologist is well equipped to understand and manage the complexities involved in educating and preparing a patient with chronic kidney disease to embrace the challenges involved with renal replacement therapy. The importance of vascular access in providing adequate dialysis therapy cannot be overemphasized. Unfortunately, it remains a weak link in providing optimal care and a major cause of morbidity and mortality. The timely diagnosis of a dysfunctional vascular access involves implementing a good monitoring and surveillance program. A nephrologist of the millennium needs to be well equipped with skills to perform procedures such as fistulogram, percutaenous angioplasty, endovascular thrombectomy and occasionally placement of stents and coils for timely intervention of a dysfunctional access. The current review describes the basic procedures that can be easily performed by nephrologists to provide ideal care to dialysis patients.