Effects of Interventional Medicine in Nephrology

Alan Yu, MD, Director, Kidney Institute

More than 871,000 people in the United States are being treated for end-stage renal disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Of those patients, more than 365,000 receive renal replacement through hemodialysis.

For these patients, vascular access is both a lifeline and an Achilles' heel. While arteriovenous fistulas and grafts are vital for dialysis, they are susceptible to stenosis, thrombosis and infection. When these complications occur, prompt treatment is critical to a patient’s survival.

Hospital admissions for vascular access infection rose steadily nationwide until 2005. Since that peak, admissions have fallen 24 percent. A portion of this decline may be attributed to the rise of interventional medicine in nephrology.

Interventional procedures

Interventional procedures can quickly clear arteriovenous fistulas for hemodialysis without open surgery and provide better patient outcomes. Such procedures include catheter placement, fistulograms, percutaneous balloon angioplasties, thrombectomies, venous mapping and kidney biopsies.

At The University of Kansas Hospital, our nephrologists work alongside interventional radiologists, providing them with key knowledge about dialysis, the potential complications of vascular access, and the effects of complications on patients’ treatments and quality of life. Using minimally invasive procedures and this multidisciplinary approach, we may quickly treat clots or failures of arteriovenous fistulas and grafts, renal artery stenosis and many, if not all, vascular access complications.

Improved care leads to lower overall costs

For patients, the power of interventional nephrology is realized in the reduction of emergency treatments and hospitalizations. Studies have shown interventional nephrology programs decrease the number of hospitalizations and missed dialysis treatments. However, beyond interventional nephrology’s positive effect on patient care, there is an undeniable financial impact.

In 2010, Medicare expenditures surpassed $30 billion with total end-stage renal disease, or ESRD, expenditures amounting to $47.5 billion. A significant proportion of these costs were due to complications of vascular access, emergency dialysis and hospitalizations of patients with ESRD.

World-class kidney care

For the past four years, The University of Kansas Hospital’s nephrology program has ranked among the nation’s best in U.S. News & World Report’s Best Hospitals. Nephrology ranked No. 15 among the nation’s top 50 for 2012-13. We offer superb clinical fellowship training, a widely respected clinical program and a strong tradition in translational medicine that integrates scientific research with clinical trials.

To consult with one of our nephrologists, call 913-588-5862 or toll free 877-588-5862. Learn more.

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