Physicians
and
Dialysis Units
The Dialysis Access Center is committed to fostering strong relationships with physicians and dialysis units by providing a dedicated platform to provide quality care for dysfunctional accesses. This page serves as a valuable resource, offering comprehensive insights that empower healthcare professionals with the latest advancements and best practices in dialysis care. Through this initiative, we aim to enhance collaboration and ensure optimal patient outcomes.
Indications for Evaluation
Common reasons to seek vascular access evaluation and intervention
FISTULA
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Failure to mature (should be maturing at 4-6 weeks, if not, investigate for possible inflow or outflow problems
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Difficult or painful cannulation​
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Frequent blood pump flow difficulties (BFR consistently <400 ml/min or unable to achieve prescribed BR)
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Increased venous pressure
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Prolonged bleeding (>15 minutes after dialysis)
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Arm/hand swelling
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Aneurysm
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Abnormal Transonic® flow measurements (or similar surveillance method)
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Clot(s)/ clotted
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Recirculation/inadequate dialysis
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Increased negative arterial pressures
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Hyperpulsatility or water-hammer pulse
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Accessory vessels
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Kt/V <1.2 or URR <70
GRAFT
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Clotted graft
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Abnormal Transonic® flow measurements (or similar surveilance method)
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Difficult or painful cannulation
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Poor blood flow
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Recirculation/inadequate dialysis
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Increased negative arterial pressures
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Hyperpulsatility or water-hammer pulse
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Increased venous pressure
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Prolonged bleeding
(>15 minutes after dialysis) -
Arm/hand swelling
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Psuedoaneurysm
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Kt/V <1.2 or URR <70
CATHETER
-
Removal
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Insertion
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Poor blood flow rates (should be able to consistently attain
350 ml/ min) -
Recirculation/inadequate dialysis
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Catheter migrated in or out
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'Stuttering' catheter or positional flows
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Catheter exchange for catheter-related bacteremia
VASCULAR MAPPING
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Done for optimum creation of AVF
