Day-Long Program to Provide Comprehensive Overview of Hemodialysis Issues


Optimizing care of dialysis patients will be the focus of a comprehensive program with five sessions, “New Developments in Vascular Access for Hemodialysis,” taking place all day Saturday.

“Chronic kidney disease (CKD) has become an epidemic in the United States. Medicare spending for patients with CKD ages 65 and older exceeded $50 billion in 2013 and represented 20% of all Medicare spending for this age group. This epidemic has been driven by the rise in diabetes, hypertension and obesity and has resulted in a staggering increase in the number of patients requiring hemodialysis,” stated program organizer Dr. Larry A. Scher, professor of clinical surgery at Albert Einstein College of Medicine and attending surgeon at Montefiore Medical Center.

“Providing functioning vascular access for these patients has become a significant challenge for vascular surgeons, transplant surgeons, interventional nephrologists, and interventional radiologists along with nephrologists, nurses, dialysis technicians, and others interested in optimizing the care of dialysis patients,” he continued. “These practitioners are the target audience for this program, which will address many important topics in hemodialysis access.”

There will be five sessions covering issues in the field, optimization of outcomes, political, economic and legal topics, new technologies and concepts, and updates on clinical challenges.

The first sessions will cover important issues in the field and outcome optimization. Experts will address topics such as fistula maturation, use of ultrasound for access planning and cannulation, importance of dialysis maturation, significance of dialysis blood flow, and the use of stent grafts and drug-eluting balloons. Other talks will address cognitive function in patients with chronic kidney disease, measuring cardiac output in the dialysis improve patient safety, review of significant contributions to the literature, and an update on the mission of Kidney Health International.

“We are honored to have Harald C. Ott, MD, principal investigator at the Ott Laboratory for Organ Engineering and Regeneration at Massachusetts General Hospital as our guest speaker,” said Dr. Scher. “There is a critical shortage of kidneys available for transplantation, and Dr. Ott has performed important research on reengineered organs.” His presentation will be on the revolution in renal replacement therapy, specifically the current status of the bio-artificial kidney.

“The talk should be of great interest to medical professionals interested in improving care for our patients with end-stage renal disease,” said Dr. Scher. Other session talks will discuss Medicare costs for patients on hemodialysis, changes in reimbursement for outpatient procedures, and training of vascular access surgeons.

“The segment on new technologies and concepts will present updated results of several important clinical trials, including efforts aimed at improving fistula maturation with elastase, sirolimus, and the VasQ device,” explained Dr. Scher. Results will be presented of trials of minimally invasive technologies for creating hemodialysis access. Also covered will be a unique sensor capable of providing remote monitoring of AV fistulas and grafts, as well as the RADAR technique, which emphasizes the importance of hemodynamics in arteriovenous fistula maturation.

“The final session will delve into clinical issues in hemodialysis access,” said Dr. Scher. “There will be several talks about achieving successful access in challenging patient populations including obese, elderly and hypercoagulable patients, as well as patients with implantable cardiac devices.” Subject areas will include the role of biologic grafts in hemodialysis access and management of dialysis access complications, including steal syndrome, high flow fistula, central venous stenosis, aneurysms, and infection.

“We have assembled an expert faculty that will offer a comprehensive overview of a wide-range of topics of interest to physicians and allied professionals who care for patients with end-stage renal disease,” said Dr. Scher. “Panel discussions will further enhance the program, allowing attendees to not only interact with faculty, but also discuss topics of interest and concern to their clinical practices.” ■

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