Interventional Nephrology

Interventional nephrology covers the procedures that make kidney care possible: creating and maintaining dialysis access, placing dialysis catheters and performing image-guided kidney biopsies. Depending on the hospital, the work is shared between nephrologists, interventional radiologists and vascular surgeons.

Its main goal is to keep a dialysis patient's lifeline working. A fistula or catheter that fails means missed dialysis, so narrowing and clots are treated promptly, often as day cases.

Bedingungen, die dieser Service betreut

• Need for a first arteriovenous fistula or graft before starting haemodialysis
• A fistula that is slow to mature, narrowed or clotted
• Central vein narrowing causing arm swelling
• Need for a tunnelled haemodialysis catheter
• Need for a peritoneal dialysis catheter
• Catheter malfunction or infection
• Unexplained kidney disease requiring biopsy

Tests, die Ihnen möglicherweise angeboten werden

• Vessel mapping by Doppler ultrasound: Measures arm arteries and veins to choose the site most likely to give a working fistula.
• Fistula surveillance ultrasound: Measures flow and finds narrowing before the fistula clots.
• Fistulogram: Contrast X-ray of the fistula and central veins, usually combined with treatment in the same sitting.
• Ultrasound-guided kidney biopsy: Tissue sampling for diagnosis under local anaesthetic.

Behandlungen verfügbar

• Arteriovenous fistula creation: Minor surgery under local or regional anaesthesia joining an artery and vein in the arm; needs 6 to 12 weeks to mature.
• Arteriovenous graft: A synthetic tube used when veins are too small; usable sooner but narrows more often.
• Balloon angioplasty and stenting: Opens narrowed segments of a fistula, graft or central vein.
• Thrombectomy: Removes clot from a blocked access, ideally within a day or two.
• Tunnelled dialysis catheter placement: Ultrasound and X-ray guided insertion into a neck vein for immediate or bridging access.
• Peritoneal dialysis catheter insertion: Percutaneous or laparoscopic placement of the abdominal catheter.

Wann Sie eine Fachmeinung einholen sollten

• Your kidney function is falling towards the level where dialysis will be needed within about a year
• Your dialysis unit reports falling flows, high pressures or prolonged bleeding after needling
• Your fistula's buzz (thrill) has changed or stopped
• Your fistula arm, face or neck is swelling
• Your catheter is not running well or the exit site is red or discharging

Reisen nach Türkiye für diese Pflege

Access work is tightly linked to your regular dialysis unit, which has to needle, monitor and rescue the access afterwards, so it is normally done locally. A clotted fistula must be treated within days where you are. Planned fistula creation during a longer stay, or urgent help with access problems for someone already on holiday dialysis, are the realistic scenarios abroad. Bring previous operation notes and any fistulogram images.

Senden Sie Ihre Berichte, Scans und eine kurze Geschichte und eine Clinic-Y Koordinator Antworten innerhalb von 24 Stunden mit geeigneten Teams und schriftlich, All-inclusive Vorschläge nebeneinander. Die Überprüfung Ihres Falls ist kostenlos.

Häufig gestellte Fragen