The Changing Face of Interventional Medicine - The University Of ...

Medical Advancements atThe University of Kansas HospitalEffects of Interventional Medicinein NephrologyAlan Yu, MDDirector, Kidney InstituteMore than 871,000 people in theUnited States are being treated forend-stage renal disease, accordingto the National Institute ofDiabetes and Digestive and KidneyDiseases. Of those patients, more than365,000 receive renal replacement throughhemodialysis.For these patients, vascular access isboth a lifeline and an Achilles heel.While arteriovenous fistulas andgrafts are vital for dialysis, they aresusceptible to stenosis, thrombosis andinfection. When these complicationsoccur, prompt treatment is critical to apatient’s survival.Hospital admissions for vascular accessinfection rose steadily nationwide until2005. Since that peak, admissions havefallen 24 percent. A portion of thisdecline may be attributed to the rise ofinterventional medicine in nephrology.Interventional proceduresInterventional procedures can quicklyclear arteriovenous fistulas forhemodialysis without open surgery andprovide better patient outcomes. Suchprocedures include catheter placement,fistulograms, percutaneous balloonangioplasties, thrombectomies, venousmapping and kidney biopsies.At The University of Kansas Hospital,our nephrologists work alongsideinterventional radiologists, providingthem with key knowledge about dialysis,the potential complications of vascularaccess, and the effects of complicationson patients’ treatments and qualityof life. Using minimally invasiveprocedures and this multidisciplinaryapproach, we can quickly treat clots orfailures of arteriovenous fistulas andgrafts, renal artery stenosis, and many,ifif not all, vascular access complications.Improved care leads to loweroverall costsFor patients, the power of interventionalnephrology is realized in the reductionof emergency treatments andhospitalizations. Studies have showninterventional nephrology programsdecrease the number of hospitalizationsand missed dialysis treatments.However, beyond interventionalnephrology’s positive effect on patientcare, there is an undeniable financialimpact.In 2010, Medicare expendituressurpassed $30 billion with totalend-stage renal disease, or ESRD,expenditures amounting to $47.5billion. A significant proportion ofthese costs were due to complications ofvascular access, emergency dialysis andhospitalizations of patients with ESRD.World-class kidney careFor the past four years, The Universityof Kansas Hospital’s nephrologyprogram has ranked among the nation’sbest in U.S. News & World Report’s BestHospitals. Nephrology ranked No. 15among the nation’s top 50 for 2012-13. We offer superb clinical fellowshiptraining, a widely respected clinicalprogram and a strong tradition intranslational medicine that integratesscientific research with clinical trials.To consult with one of ournephrologists, call 913-588-5862or toll free 877-588-5862. Findmore information at kumed.com.Dr. Yu is director of the division of nephrology and hypertension, and professor of medicine at the University of Kansas School ofMedicine. He is also director of the Kidney Institute at the University of Kansas Medical Center. Dr. Yu is also co-editor ofBrenner and Rector’s The Kidney, the internationally best-selling nephrology reference text.11KUMedInnovationsSummer2013_X.indd 116/13/13 10:09 AM