title: Dialysis vascular access management by interventional nephrology programs at University Medical Centers in the United States.
abstract: The development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private practice setting, several academic medical centers across the United States have now developed interventional nephrology programs. University Medical Centers (UMCs) that offer interventional nephrology face challenges, such as smaller dialysis populations, limited financial resources, and real or perceived political "turf" issues." Despite these hurdles, several UMCs have successfully established interventional nephrology as an intricate part of a larger nephrology program. This has largely been accomplished by consolidating available resources and collaborating with other specialties irrespective of the size of the dialysis population. The collaboration with other specialties also offers an opportunity to perform advanced procedures, such as application of excimer laser and endovascular ultrasound. As more UMCs establish interventional nephrology programs, opportunities for developing standardized training centers will improve, resulting in better quality and availability of nephrology-related procedures, and providing an impetus for research activities.
authors: Dialysis Access Group of Wake Forest University School of Medicine, Department of Internal Medicine/Nephrology, Winston-Salem, North Carolina 27157, USA. tvachhar@wfubmc.edu
authors: Tushar J
authors: TJ
authors: Vachharajani
authors: Shahriar
authors: S
authors: Moossavi
authors: Loay
authors: L
authors: Salman
authors: Steven
authors: S
authors: Wu
authors: Amy C
authors: AC
authors: Dwyer
authors: Jamie
authors: J
authors: Ross
authors: Ramanath
authors: R
authors: Dukkipati
authors: Ivan D
authors: ID
authors: Maya
authors: Alexander S
authors: AS
authors: Yevzlin
authors: Anil
authors: A
authors: Agarwal
authors: Kenneth D
authors: KD
authors: Abreo
authors: Jack
authors: J
authors: Work
authors: Arif
authors: A
authors: Asif
mesh_terms: D000046:Academic Medical Centers; D001166:Arteriovenous Shunt, Surgical; D002408:Catheters, Indwelling; D057510:Endovascular Procedures; D006436:Hemodialysis Units, Hospital / Q000458:organization & administration* / Q000592:standards*; D006801:Humans; D009398:Nephrology; D006435:Renal Dialysis / Q000592:standards*; D014481:United States