title: Radiation exposure in dialysis access-related procedures decreases with increase in number of procedures performed by the interventional nephrologist.
abstract: An appreciation of the inherent risks with radiation exposure to patients and to the physician performing the procedure and the staff is urgently needed. The objective of this study is to assess radiation exposure to both patients and interventional nephrologists performing procedures and see any trends in the procedure and fluoroscopy times over a 2-year period. A total of 400 procedures performed at our vascular access center by a new to practice interventional nephrologist were recorded and retrospectively analyzed. Fluoroscopic time and procedure time for various procedures over the course of 2 years were recorded. This data were subsequently separated into eight groups (four quarters per year) based on the date of the procedure. Our study demonstrates a decrease in mean and median fluoroscopy times and procedure times for newly trained interventional with gain in number of procedures. The mean fluoroscopy time for the first two quarters was 5 minutes and 4 seconds, and the median was 3 minutes and 37 seconds. The mean procedure time for the first two quarters was 38 minutes, and the median was 32 minutes. The mean fluoroscopy time for the last two quarters was 1 minute and 54 seconds, and the median was 1 minute and 26 seconds. The mean procedure time for the last two quarters was 27 minutes, and the median was 21 minutes. In conclusion, gain of experience by the practicing Interventional Nephrologist from performing an increasing number of procedures leads to decreased procedure times and fluoroscopy times, which lowers the risk of radiation.
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center and the David Geffen School of Medicine at UCLA, Torrance and Los Angeles, California 90509, USA. ramdukkipati@gmail.com
authors.forename: Ramanath
authors.initials: R
authors.lastname: Dukkipati
authors.forename: Gautam
authors.initials: G
authors.lastname: Tammewar
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.forename: Rajiv
authors.initials: R
authors.lastname: Dhamija
mesh_terms: D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling; D004307:Dose-Response Relationship, Radiation; D005471:Fluoroscopy / Q000639:trends*; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control; D011834:Radiation Monitoring / Q000379:methods; D015642:Radiology, Interventional / Q000379:methods / Q000639:trends*; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors