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Role of interventional nephrology in the multidisciplinary approach to hemodialysis vascular access care.

Beathard GA - Kidney Res Clin Pract (2015)

Bottom Line: Most of these interventional nephrologists work in freestanding outpatient dialysis access centers (DACs).Large clinical studies published over the past 10 years demonstrate that the interventional nephrologist can manage the problems associated with dialysis access dysfunction effectively, safely, and economically.A recently published study based upon United States Medicare claims data in which a DAC patient group (n = 27,613) and a hospital outpatient department patient group (HOPD group; n = 27,613) were compared using propensity score matching techniques showed that patients treated in the DACs had significantly better clinical outcomes (P<0.001).

View Article: PubMed Central - PubMed

Affiliation: University of Texas Medical Branch and Lifeline Vascular Access, Houston, Texas, USA.

ABSTRACT
Dialysis vascular access planning, creation, and management is of critical importance to the dialysis patient population. It requires a multidisciplinary approach involving patients and their families, dialysis facility staff, the nephrologist, the surgeon, and the interventionalist. With the emergence of interventional nephrology as a subspecialty of nephrology, the nephrologist is increasingly providing both the nephrology and interventional aspects of care, and in some areas, the surgical functions as well. Most of these interventional nephrologists work in freestanding outpatient dialysis access centers (DACs). Large clinical studies published over the past 10 years demonstrate that the interventional nephrologist can manage the problems associated with dialysis access dysfunction effectively, safely, and economically. A recently published study based upon United States Medicare claims data in which a DAC patient group (n = 27,613) and a hospital outpatient department patient group (HOPD group; n = 27,613) were compared using propensity score matching techniques showed that patients treated in the DACs had significantly better clinical outcomes (P<0.001). This included fewer vascular access-related infections (0.18 vs. 0.29), fewer septicemia-related hospitalizations (0.15 vs. 0.18), and a lower mortality rate (47.9% vs. 53.5%).

No MeSH data available.


Related in: MedlinePlus

Case distribution for IN facility. This is based on 100,000 procedures performed in 75 facilities for the year 2014.Angio, angiogram; Cath, catheter-based procedures; Clin exam, clinical examination; IN, interventional nephrology; Other, miscellaneous procedures; PTA, percutaneous transluminal angioplasty; Throm, thrombectomy; Vasc map, vascular mapping.
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f0005: Case distribution for IN facility. This is based on 100,000 procedures performed in 75 facilities for the year 2014.Angio, angiogram; Cath, catheter-based procedures; Clin exam, clinical examination; IN, interventional nephrology; Other, miscellaneous procedures; PTA, percutaneous transluminal angioplasty; Throm, thrombectomy; Vasc map, vascular mapping.

Mentions: In practice, although some would want to broaden the definition, the term interventional nephrology has come to be defined as that branch of nephrology that deals with the establishment and maintenance of dialysis access, particularly arteriovenous access. A tabulation of the variety of procedures performed in a typical group of facilities is shown in Fig. 1. In the United States, most interventional nephrologists work in freestanding dialysis access centers (DACs), which are designed, equipped, staffed, and supplied specifically for dialysis vascular access management procedures. Their primary goal is to provide an efficient and economical alternative for managing access dysfunction away from the hospital setting. Their efficiency allows for a patient with a thrombosed vascular access to receive therapy and return to the dialysis clinic within a matter of hours, thus avoiding missed treatments.


Role of interventional nephrology in the multidisciplinary approach to hemodialysis vascular access care.

Beathard GA - Kidney Res Clin Pract (2015)

Case distribution for IN facility. This is based on 100,000 procedures performed in 75 facilities for the year 2014.Angio, angiogram; Cath, catheter-based procedures; Clin exam, clinical examination; IN, interventional nephrology; Other, miscellaneous procedures; PTA, percutaneous transluminal angioplasty; Throm, thrombectomy; Vasc map, vascular mapping.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608876&req=5

f0005: Case distribution for IN facility. This is based on 100,000 procedures performed in 75 facilities for the year 2014.Angio, angiogram; Cath, catheter-based procedures; Clin exam, clinical examination; IN, interventional nephrology; Other, miscellaneous procedures; PTA, percutaneous transluminal angioplasty; Throm, thrombectomy; Vasc map, vascular mapping.
Mentions: In practice, although some would want to broaden the definition, the term interventional nephrology has come to be defined as that branch of nephrology that deals with the establishment and maintenance of dialysis access, particularly arteriovenous access. A tabulation of the variety of procedures performed in a typical group of facilities is shown in Fig. 1. In the United States, most interventional nephrologists work in freestanding dialysis access centers (DACs), which are designed, equipped, staffed, and supplied specifically for dialysis vascular access management procedures. Their primary goal is to provide an efficient and economical alternative for managing access dysfunction away from the hospital setting. Their efficiency allows for a patient with a thrombosed vascular access to receive therapy and return to the dialysis clinic within a matter of hours, thus avoiding missed treatments.

Bottom Line: Most of these interventional nephrologists work in freestanding outpatient dialysis access centers (DACs).Large clinical studies published over the past 10 years demonstrate that the interventional nephrologist can manage the problems associated with dialysis access dysfunction effectively, safely, and economically.A recently published study based upon United States Medicare claims data in which a DAC patient group (n = 27,613) and a hospital outpatient department patient group (HOPD group; n = 27,613) were compared using propensity score matching techniques showed that patients treated in the DACs had significantly better clinical outcomes (P<0.001).

View Article: PubMed Central - PubMed

Affiliation: University of Texas Medical Branch and Lifeline Vascular Access, Houston, Texas, USA.

ABSTRACT
Dialysis vascular access planning, creation, and management is of critical importance to the dialysis patient population. It requires a multidisciplinary approach involving patients and their families, dialysis facility staff, the nephrologist, the surgeon, and the interventionalist. With the emergence of interventional nephrology as a subspecialty of nephrology, the nephrologist is increasingly providing both the nephrology and interventional aspects of care, and in some areas, the surgical functions as well. Most of these interventional nephrologists work in freestanding outpatient dialysis access centers (DACs). Large clinical studies published over the past 10 years demonstrate that the interventional nephrologist can manage the problems associated with dialysis access dysfunction effectively, safely, and economically. A recently published study based upon United States Medicare claims data in which a DAC patient group (n = 27,613) and a hospital outpatient department patient group (HOPD group; n = 27,613) were compared using propensity score matching techniques showed that patients treated in the DACs had significantly better clinical outcomes (P<0.001). This included fewer vascular access-related infections (0.18 vs. 0.29), fewer septicemia-related hospitalizations (0.15 vs. 0.18), and a lower mortality rate (47.9% vs. 53.5%).

No MeSH data available.


Related in: MedlinePlus