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Early referral for access evaluation

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“A best case scenario is when a nephrologist refers a patient to a surgeon within a year of the individual needing dialysis,” explains Charles Field, MD, a Virtua vascular surgeon, specializing in access placement for dialysis. “Patients not seen for early access evaluation run the risk of unexpectedly experiencing total kidney failure and then, virtually overnight, needing a temporary catheter placed either in their neck, chest or leg vein.”

In most cases, this can be avoided by early evaluation, giving the surgeon enough time to locate the optimal access placement; allowing adequate time for the fistula or graft to heal and for the patient to become accustomed to a new phase of treatment.

Dr. Field: “The most long-lasting access is a fistula joining a vein and artery, which like all access connections is evaluated with an ultrasound to map the venous and arterial anatomy for size and patency.”