Dialysis vascular access management by interventional nephrology programs at University Medical Centers in the United States.


:The development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private practice setting, several academic medical centers across the United States have now developed interventional nephrology programs. University Medical Centers (UMCs) that offer interventional nephrology face challenges, such as smaller dialysis populations, limited financial resources, and real or perceived political "turf" issues." Despite these hurdles, several UMCs have successfully established interventional nephrology as an intricate part of a larger nephrology program. This has largely been accomplished by consolidating available resources and collaborating with other specialties irrespective of the size of the dialysis population. The collaboration with other specialties also offers an opportunity to perform advanced procedures, such as application of excimer laser and endovascular ultrasound. As more UMCs establish interventional nephrology programs, opportunities for developing standardized training centers will improve, resulting in better quality and availability of nephrology-related procedures, and providing an impetus for research activities.


Semin Dial


Seminars in dialysis


Vachharajani TJ,Moossavi S,Salman L,Wu S,Dwyer AC,Ross J,Dukkipati R,Maya ID,Yevzlin AS,Agarwal A,Abreo KD,Work J,Asif A




Has Abstract


2011-09-01 00:00:00












  • Electrolyte disturbances in the intensive care unit.

    abstract::The development of many electrolyte disturbances in the ICU can be prevented by attention to the use of intravenous fluids and nutrition. Hyponatremia is a relative contraindication to the use of hypotonic intravenous fluids and hypernatremia calls for the administration of water. Formulae have been devised to guide t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Sedlacek M,Schoolwerth AC,Remillard BD

    更新日期:2006-11-01 00:00:00

  • Cerebral ischemia during hemodialysis-finding the signal in the noise.

    abstract::Hemodialysis patients have multiple risk factors for small vessel cerebrovascular disease and cognitive dysfunction. Hemodialysis itself may cause clinically significant neurological injury through repetitive cerebral ischemia. However, supporting evidence to date consists of epidemiological associations, expert opini...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审


    authors: MacEwen C,Watkinson P,Tarassenko L,Pugh C

    更新日期:2018-05-01 00:00:00

  • Management of hyperkalemia in dialysis patients.

    abstract::Hyperkalemia is common in patients with end-stage renal disease, and may result in serious electrocardiographic abnormalities. Dialysis is the definitive treatment of hyperkalemia in these patients. Intravenous calcium is used to stabilize the myocardium. Intravenous insulin and nebulized albuterol lower serum potassi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Putcha N,Allon M

    更新日期:2007-09-01 00:00:00

  • Pathogenic effects of a high peritoneal transport rate.

    abstract::Recent studies have shown that patients with high peritoneal transport characteristics have substantially increased morbidity and mortality. This finding is counter-intuitive, since HTs will a priori achieve higher clearances. There are many possible causes: increased protein losses with consequent hypoalbuminemia; po...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Heaf J

    更新日期:2000-05-01 00:00:00

  • Sympathetic overactivity in dialysis patients-Underappreciated and clinically consequential.

    abstract::Cardiovascular morbidity and mortality remain frustratingly common in dialysis patients. A dearth of established evidence-based treatment calls for alternative therapeutic avenues to be embraced. Sympathetic hyperactivity, predominantly due to afferent nerve signaling from the diseased native kidneys, has been establi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Hoye NA,Wilson LC,Jardine DL,Walker RJ

    更新日期:2019-05-01 00:00:00

  • The other side of the coin: impact of toxin generation and nutrition on the uremic syndrome.

    abstract::Both the morbidity of the uremic syndrome and the generation of uremic toxins are attributed to malnutrition. If protein intake and catabolism result in the generation of solutes, then nutritional intake should be related directly to toxicity. On the other hand, inadequate nutrition has been linked to inflammation and...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Vanholder R,Glorieux G,Lameire N

    更新日期:2002-09-01 00:00:00

  • Removal of Phosphorus by Hemodialysis.

    abstract::The control of serum phosphorus by dialysis is made difficult by the fact that intradialytic blood levels tend to be low, and because phosphorus is removed almost exclusively from the plasma during its passage through the dialyzer. The most practical way to increase phosphorus removal is to extend dialysis time, altho...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Daugirdas JT

    更新日期:2015-11-01 00:00:00

  • Therapeutic plasma exchange for renal-related conditions in the elderly: ten years experience in one center.

    abstract::The elderly people, 65 years old and above, are growing in number. The structural and functional changes associated with aging place the elderly at risk when challenged by extracorporeal therapies, such as therapeutic plasma exchange (TPE). We retrospectively analyzed data on all patients who underwent TPE for renal i...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Hayes JS,Balogun RA,Chang J,Abdel-Rahman EM

    更新日期:2012-03-01 00:00:00

  • Central vein hardware: cannot live with it, cannot live without it.

    abstract::Central vein catheters for dialysis have become an integral and unavoidable access modality for providing hemodialysis therapy despite all their major drawbacks. We report a clinical decision dilemma that every nephrologist will encounter while considering an ideal dialysis access for the steadily aging dialysis popul...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Vachharajani TJ,Moossavi S,Kaufman T,Rocco M

    更新日期:2009-09-01 00:00:00

  • Extracorporeal treatment of cast nephropathy.

    abstract::Acute kidney injury (AKI) is common in patients with multiple myeloma (MM), most commonly caused by cast nephropathy resulting from precipitation of free light chains (FLC) in renal tubules. AKI may be irreversible and require dialysis and predicts a poor prognosis. Reduction in serum FLC concentration is thought to b...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Gakhar B,Kobrin S,Berns JS

    更新日期:2011-01-01 00:00:00

  • Incremental peritoneal dialysis: New ideas about an old approach.

    abstract::Coping with the transition from end-stage kidney disease to dialysis can be challenging for patients and their care partners. Introducing incident dialysis patients to incremental forms of dialysis is associated with better quality of life and reduced cost. Incremental hemodialysis (HD) has generated significant inter...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Auguste BL,Bargman JM

    更新日期:2018-09-01 00:00:00

  • Inadequate treatment of congestive heart failure in dialysis patients.

    abstract::Congestive heart failure (CHF) is highly prevalent in patients on renal replacement therapy and is a leading cause of death in such patients. Several studies suggest that therapeutic agents for the treatment of CHF, particularly angiotensin converting enzyme inhibitors and beta-blockers, are underused in end-stage ren...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Bouchard J,Madore F

    更新日期:2007-09-01 00:00:00

  • Anemia management in cancer patients with chronic kidney disease.

    abstract::Cancer and kidney disease are linked by causality and comorbidities. Observational data show an increased risk of malignancy as renal function declines. Erythropoietin stimulating agents (ESAs), which are the cornerstone therapy for anemia patients with chronic kidney disease and cancer, are associated with increased ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Latcha S

    更新日期:2019-11-01 00:00:00

  • APD in the developing world: is there a future?

    abstract::Automated peritoneal dialysis (APD) has experienced significant growth in highly developed nations in the last few years, while in developing countries with important social, educational, and financial constraints this treatment modality is, at best, trying to emerge. APD offers advantages that make it popular. Some o...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Correa-Rotter R

    更新日期:2002-11-01 00:00:00

  • Transplantation in diabetic kidney failure patients: modalities, outcomes, and clinical management.

    abstract::Diabetes mellitus (DM) is a common and devastating disease, affecting up to 19.3 million Americans. It is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States. Diabetic patients with ESRD have a high incidence of cardiovascular disease and death. For those kidney tr...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Luan FL,Samaniego M

    更新日期:2010-03-01 00:00:00

  • Fragmentation of care as a barrier to optimal ESKD management.

    abstract::Caring for patients with end-stage kidney disease (ESKD) in the United States is challenging, due in part to the complex epidemiology of the disease's progression as well as the ways in which care is delivered. As CKD progresses toward ESKD, the number of comorbidities increases and care involves multiple healthcare p...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Sloan CE,Zhong J,Mohottige D,Hall R,Diamantidis CJ,Boulware LE,Wang V

    更新日期:2020-11-01 00:00:00

  • Drug therapy for hypertension in hemodialysis patients.

    abstract::The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease mo...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Hörl MP,Hörl WH

    更新日期:2004-07-01 00:00:00

  • Endotoxemia in end-stage kidney disease.

    abstract::Chronic unexplained inflammation remains a prevalent and clinically significant problem for patients with end-stage kidney disease (ESKD), especially in the dialysis population. The causes of persistent inflammation are likely to be multifactorial, but the underlying mechanisms remain to be elucidated. Endotoxins are ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Wong J,Vilar E,Farrington K

    更新日期:2015-01-01 00:00:00

  • Timing of dialysis initiation in acute kidney injury and acute-on-chronic renal failure.

    abstract::The decision to provide dialytic support and choosing the ideal moment to initiate therapy are common impasses for physicians treating patients with acute kidney injury (AKI). Although renal replacement therapy (RRT) has been extensively used in clinical practice for more than 30 years, there is a paucity of evidence ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Macedo E,Mehta RL

    更新日期:2013-11-01 00:00:00

  • Improving access to renal transplantation.

    abstract::Kidney transplantation is the treatment of choice for most patients with end-stage renal disease (ESRD), with success rates greater than were envisioned as recently as a decade ago. Unfortunately this trend has created unprecedented demand for transplantable organs and new challenges for those desiring transplantation...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Gaston RS

    更新日期:2005-11-01 00:00:00

  • Identification of facilitators and barriers to home dialysis selection by canadian adults with ESRD.

    abstract::Home dialysis (home HD or home PD) remains underutilized in most jurisdictions. Physicians, advanced-practice nurses, and policy makers working with chronic kidney disease populations can provide insights into patient, healthcare professional, and system-level barriers to home dialysis selection by suitable patients. ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Osterlund K,Mendelssohn D,Clase C,Guyatt G,Nesrallah G

    更新日期:2014-03-01 00:00:00

  • Doppler ultrasound: a powerful tool for vascular access surveillance.

    abstract::National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) guidelines recommend Doppler ultrasound (DU) for surveillance of vascular access (VA), but trials have not been unanimous about its benefit on VA patency. The aim of this study was to evaluate the accuracy of DU for patency, as well as t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Guedes Marques M,Ibeas J,Botelho C,Maia P,Ponce P

    更新日期:2015-03-01 00:00:00

  • The medical-legal responsibilities of a dialysis unit medical director.

    abstract::The specialty of Nephrology, by virtue of its relationship with the dialysis procedure, is highly vulnerable to litigation. As is the case with all nephrologists, a dialysis unit medical director is not immune to medical malpractice suits, and can be held liable for any act of perceived or potential harm to any dialys...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Vaqar S,Murray B,Panesar M

    更新日期:2014-09-01 00:00:00

  • Past, present, and future of quantified peritoneal dialysis.

    abstract::The role of peritoneal dialysis (PD) as a modality in renal replacement therapy has been well established. In this article we review various aspects in the evolution of PD, with special emphasis on adequacy. Until the late 1950s PD was still considered as a last resort in the treatment of terminal uremia. The introduc...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Haq NU,Nolph KD

    更新日期:2001-07-01 00:00:00

  • Dialysis access failure: an indication for immediate kidney transplantation.

    abstract::In the United States, presently there are more than 50,000 patients with end-stage renal disease (ESRD) awaiting a cadaveric kidney and each year less than a quarter receive kidney transplantation. Although the real incidence in unknown, a significant number of these patients die due to lack of dialysis access. While ...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Laskow DA,Ahsan N

    更新日期:2002-01-01 00:00:00

  • In-center thrombolysis for clotted AV access: a cohort review.

    abstract::Thrombosis is the leading cause of arteriovenous (AV) access failure for hemodialysis patients requiring frequent interventions. We describe a novel approach to the lyse-and-wait technique in thrombosed AV access using nurse-administered thrombolytics in a hospital-based hemodialysis unit. All patients at a single-cen...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Umanath K,Morrison RS,Christopher Wilbeck J,Schulman G,Bream P,Dwyer JP

    更新日期:2013-01-01 00:00:00

  • A position statement from the American Society of Diagnostic and Interventional Nephrology.

    abstract::A procedure-related complication is an unanticipated adverse event that requires therapy. In order to analyze frequency and severity of complications in the process of quality assurance, it is useful to have a classification of complications, indicating the type and severity. The Clinical Practice Committee of America...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Vesely TM,Beathard G,Ash S,Hoggard J,Schon D,ASDIN Clinical Practice Committee.

    更新日期:2007-07-01 00:00:00

  • Blood pressure control in conventional hemodialysis.

    abstract::Hypertension among patients on hemodialysis is common, difficult to diagnose and often inadequately controlled. Although specific blood pressure (BP) targets in this particular population are not yet established, meta-analyses of randomized trials showed that deliberate BP-lowering with antihypertensive drugs improves...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Georgianos PI,Agarwal R

    更新日期:2018-11-01 00:00:00

  • Iron and infection in hemodialysis patients.

    abstract::Intravenous iron is an important component of the treatment of anemia of end-stage renal disease (ESRD), but it is biologically plausible that iron could increase the risk of infection through impairment of neutrophil and T-cell function and promotion of microbial growth. Any such increase in risk would be particularl...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Ishida JH,Johansen KL

    更新日期:2014-01-01 00:00:00

  • Role of parathyroid hormone and therapy with active vitamin D sterols in renal osteodystrophy.

    abstract::Renal osteodystrophy (ROD) represents a spectrum of bone lesions ranging from a high-turnover to a low-turnover state. The expression of the histologic bone lesions is modulated by parathyroid hormone (PTH), vitamin D, calcium, phosphorus, and aluminum that act as major regulators of osteoblastic activity and bone for...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Hernandez JD,Wesseling K,Salusky IB

    更新日期:2005-07-01 00:00:00