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Invasive and innovative nephrology.

Tushar J Vachharajani1, Naveen K Atray

  • 1Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana 71101, USA. Tushar.vachharajani@med.va.gov

Renal Failure
|June 17, 2005
PubMed
Summary

Interventional nephrology successfully provides comprehensive renal failure care for veterans at OBVAMC. This program demonstrates the feasibility of developing similar services in other tertiary care hospitals.

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Area of Science:

  • Nephrology
  • Interventional Nephrology
  • Vascular Access

Background:

  • Comprehensive care for renal failure patients is evolving with interventional nephrology.
  • Overton Brooks Veterans Affairs Medical Center (OBVAMC) pioneered federal interventional nephrology services.
  • Logistical challenges, including limited interventional radiologists, spurred the program's development.

Purpose of the Study:

  • To report the early experience and outcomes of an interventional nephrology program at OBVAMC.
  • To demonstrate the successful provision of complete renal failure care despite obstacles.

Main Methods:

  • Analysis of all procedures performed between June 2000 and September 2003 at OBVAMC.
  • Procedures were conducted in cardiac catheterization or surgical operating rooms.
  • Focus on vascular access and related interventions for renal failure patients.

Main Results:

  • A total of 366 procedures were performed, including catheter placements, removals, fistulograms, thrombectomy/angioplasty, and stent placement.
  • Specific procedures included 110 tunneled cuffed catheter (TCC) placements and 157 temporary dual lumen catheters.
  • A single complication of bleeding from a TCC exit site was reported.

Conclusions:

  • The interventional nephrology program at OBVAMC has yielded encouraging results, providing optimal care for veterans.
  • The OBVAMC experience suggests that interventional nephrology programs are viable in tertiary care settings.

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