Sensing Savvy

Chronic kidney disease (CKD) is the slow break down of our kidneys' ability to filter fluid and waste products from our blood. The disease afflicts more than 2 million persons

worldwide and more than 650,000 persons in the United States. Kidneys don’t typically fail all at once, but their function usually declines slowly over a period of years. Frequently, CKD does not present symptoms in its early stages so it is often called “a silent killer.”

As an end-stage-renal disease (ESRD) hemodialysis patient, your access is your link to life. Knowing the blood flow in your access by Transonic Hemodialysis Monitor measurements is critical for your well being. But what can you do if you discover that your flows are trending down? First, you should talk with your nephrologist about your flows and solicit his or her feedback.

But what more can one do? It takes only a minute each day to check your access to safeguard your lifeline.

The Hospital Readmissions Reduction Program (HRRP) established in the Affordable Care Act has further focused hospital efforts to improve quality and patient outcomes.

In a Medicare Payment Advisory Commission (MedPAC) report to Congress, coronary artery bypass graft (CABG) surgery was ranked as having the highest potentially preventable readmission rate. Volume flow measurement provides an objective, intraoperative assessment of the quality and patency of grafts and could help prevent costly re-operations and readmissions.

Chairman, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation87th AATS President (2006-2007)

Researchers found that CKD patients may get some medicinal benefits from consuming caffeine. They found that those who consumed higher amounts of caffeine—between 206.5 to 1,378.5 milligrams daily—cut their mortality risk by nearly a quarter compared to those who consumed lower amounts.

The Thelma and Henry Doelger Professor of Cardiovascular Surgery Stanford University 88th AATS President (2007-2008)

Dr. D. Craig Miller, the Thelma and Henry Doelger Professor of Cardiovascular Surgery at Stanford University, is, by his own admission, a cowboy and a maverick. He attributes his independent nature to growing up on cattle ranches owned and run by his physician father in northern California.

Physicians are under a lot of pressure to deliver high-quality care to every patient. Over time, this pressure can lead to symptoms of burnout and, in more severe cases, even suicide.

While many physicians experience these feelings, they have a tendency to put their mental health on the back burner. But self-care can help avoid personal conflicts as well as potential patient risks.

Here are some ways to weave self care into your schedule.

Stuart W. Harrington Professor of Surgery, Mayo Clinic, Rochester, MN 93rd AATS President (2012-2013)

Chairman Emeritus, New York University School of Medicine
63rd AATS President (1982-1983)

The National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines call for monitoring and surveillance of vascular accesses to proactively identify access complications so that they can be resolved early. Moreover, the KDOQI Guidelines recommend that access blood flow assessment be performed within the first 1.5 hours after the beginning of a dialysis treatment. In a busy high volume dialysis clinic, it might be logistically impossible to perform surveillance of all patients within the first 1.5 hour of dialysis. So the question surfaces, “Does it really matter when surveillance takes place?”