Kidney Disease and Renal Failure

Vascular Access for a patient with Kidney Disease or Renal Failure or who is or may be a Dialysis Patient requires the Clinician to evaluate additional facts and data. This page describes important factors for the Vascular Access Clinician to consider.

Chronic Kidney Disease or Renal Failure

Chronic Kidney Disease or Renal Failure is the malfunction of the kidneys causing the kidneys to lose their filtering ability. As a result of kidney disease, kidney failure or kidney injury, waste accumulates in the body and the body’s chemical balance gets disrupted. Symptoms of Kidney Disease and Renal Failure include fluid retention, fatigue, shortness of breath and decreased urine output.

Kidney Disease or Renal Failure

Human Kidney with cross section of inner organ

Kidney Disease or Renal Failure

Arteriovenous Fistula surgery for Dialysis Patient

Kidney Disease Treatment – Dialysis

Kidney Disease Treatment can consist of Dialysis. In order for permanent dialysis to be done, a vascular surgeon will connect a patient’s vein and artery so that the dialysis machine can attach directly to the patient’s bloodstream. This is called Arteriovenous fistula (AV), meaning an abnormal connection between an artery and vein, which in the case of dialysis, is monitored by a patient’s doctor.

Vascular Access – Dialysis Patient

Vascular Access for a Dialysis patient or a potential Dialysis patient requires advanced Vascular Access skills and experience.  Patients with Kidney Disease tend to have stenosis of the veins, meaning the thickening, hardening, stiffening, and narrowing of the veins.  Between this and AV surgery, described above, a Dialysis patient requiring Vascular Access has special needs; primarily, the need to preserve veins.  According to the Kidney Disease Outcomes Quality Initiative (KDOQI) Vascular Access Guidelines, by avoiding PICCs and Midlines and other Vein Punctures in the upper extremities (ie, upper arm), the life of the patient can be extended by 5-7 additional years.  Veins are not renewable resources and in the renal population, (a) veins and arteries in the upper extremities must be preserved and (b) any AV surgery and connection between an artery and vein must not be disturbed so that it can used and access as long as possible – which is usually up to 3 times/week.

Veins must be Preserved for Treatment

Veins must be Preserved for Treatment

Small Bore Internal Jugular Central Venous Line

Small Bore Internal Jugular Line or Femoral Line avoids and preserves Veins & Arteries in Upper Arms

Small Bore Internal Jugular Central Venous Catheter Line

Small Bore Internal Jugular Central Venous Catheter Line is the solution, with a Small Bore Femoral Central Venous Catheter Line and a Small Bore Axillary Central Venous Catheter Line as additional alternatives.  These central catheter lines preserve veins and arteries in the upper arms, enable future AV Fistula surgery, and do not disturb any current AV surgical connection between the vein and artery in the arm.

Vascular Wellness – Patient with Kidney Disease

Vascular Wellness clinicians have enabled Vascular Access for many dialysis patients.  Vascular Wellness has the experience and expertise to place small bore central catheter lines at similar very high success rates and zero insertion related infections as we do with PICCs.  In fact, Vascular Wellness has placed over 15,000 Small Bore Internal Jugular Central Venous Catheter Lines with no insertion related infections.  Unlike Large Bore Central Venous Lines, Small Bore Central Venous Lines allow the patients the travel across any care setting including in the privacy of their home.   

Small Bore Femoral Central Venous Line

Small Bore Central Venous Lines allow the patients the travel across any care setting

Vascular Wellness maintains a clean, sterile field for Vascular Access Lines segregating such Lines from the dirty, non-sterile side, for infection control and to help prevent infections

Vascular Wellness maintains a clean, sterile field for Vascular Access Lines segregating such Lines from the dirty, non-sterile side, for infection control and to help prevent infections

Vascular Wellness – Patient Treatment Team

Vascular Wellness serves as a valuable contributor to the patient treatment team.  We work closely with the Nephrologist to help ensure the right Vascular Access procedure is done and often, the Nephrologist either initially prefers the Small Bore Internal Jugular Central Venous Catheter Line or after a short consultation with the Vascular Wellness clinician.  If a patient has a serum creatinine greater than 2 milligrams per deciliter, a GFR less than 44, or only one kidney due to congenital history, carcinoma, or other renal injury, Vascular Wellness will not perform a PICC or Midline without a documented medical order from the Nephrologist or other appropriate medical doctor.  Vascular Wellness is a comprehensive Vascular Access Solution with the tools and training to provide the right Vascular Access at the Right Time.

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Vascular Wellnesssm provides vascular access clinical nursing services at the bedside across the southeast to a diverse client base including hospitals, long term acute care centers, surgical and outpatient centers, skilled nursing facilities, and at-home care.

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Cary, NC 27519
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