Preserving Hemodialysis

Preserving Hemodialysis Access for Patients Requiring Dialysis

Patients with chronic renal failure need regular hemodialysis that performs the kidney's job of ridding the body of toxic waste products, and to maintain fluid, electrolyte and acid-base balance. One of the greatest challenges facing patients and their doctors is keeping the vascular access open for dialysis. Most patients with chronic renal failure receive dialysis using surgical fistulas, or grafts made of polytetrafluoroethylene (PTFE). These tend to clot or malfunction, decreasing reliable access for life-sustaining dialysis and causing considerable morbidity, discomfort and inconvenience for dialysis patients.

Currently, there are about 250,000 Medicare patients undergoing hemodialysis in the United States, and half or more will have at least one episode of clotting (thrombosis) of the fistula or graft. Some thrombosed fistulas or grafts require surgery to fix, but interventional radiologists are increasingly providing nonsurgical dialysis declotting. These interventions are safer, less costly, and equally effective and they improve the quality of life for dialysis patients.