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 personsworldwide 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.
Chairman, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation87th AATS President (2006-2007)
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.
Stuart W. Harrington Professor of Surgery, Mayo Clinic, Rochester, MN 93rd AATS President (2012-2013)
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?”
Chair, Department of Surgery; Surgeon-in-Chief, New York-Presbyterian Hospital/Columbia University Medical Center
92th AATS President (2011-2012)
The National Kidney Foundation (NKF) is celebrating the 20th Anniversary of the Kidney Disease Outcomes Quality Initiative (KDOQI) with release of a KDOQI 20th Anniversary Video. The video highlights the importance of the guidelines to kidney patient care and includes interviews with some of the most prominent nephrologists, many of whom worked on the original DOQI and KDOQI guidelines.
NKF published its first evidence-based clinical practice guidelines in nephrology under the Dialysis Outcomes Quality Initiative (DOQI) banner in 1997. DOQI w
as soon expanded to KDOQI as the need to treat kidney disease earlier to improve outcomes for all patients with kidney disease was recognized.
In 2013, Medicare spent nearly $33 billion to care for persons with end-stage renal disease (ESRD). Dialysis patients are hospitalized nearly twice per year on an average and spend about 11 days in the hospital per year. Such hospitalizations account for about 40% of Medicare expenditures for dialysis patients. Moreover, Medicare’s medium per-patient cost for the last 30 days of life was $20,731 in 2013.