Nephrologists

The following are some specific things nephrologists can do to begin to increase AV fistula use in dialysis patients. These are actions that you can take immediately; they will require cooperation between and, perhaps, changes in practice of, all providers in the system.

Know the rates of AV fistula prevalence and incidence for your patients.
Review the recommended strategies from the Fistula First Change Package and choose those that make the most sense for your practice.

Consider getting started with the following changes:

Change Concept 2 - Timely Referral to Nephrologist

Change Concept 3 - Early Referral to surgeon for "AVF Only" Evaluation and Timely Placement

Change Concept 4 - Surgeon Selection Based on Best Outcomes, Willingness, and Ability to Provide Access Services

Change Concept 6 - Secondary AVF Placement in Patients with AV Grafts

Change Concept 7 - AVF Placement in Patients with Catheters Where Indicated

Change Concept 9 - Monitoring and Maintenance to Ensure Adequate Access Function

Change Concept 10 - Education for Caregivers and Patients

Change Concept 11 - Outcomes Feedback to Guide Practice

Educational Materials

The following articles and slide programs are designed for nephrologists to enhance understanding of their role as nephrology team leaders, and to provide information on vascular access surgical procedures and tools to assist with interactions with colleagues.

Autologous AVF Options

Biology of AVF Failures

Clinical Epidemiology of AVF in 2007

Vascular Mapping Techniques - Advantages & Disadvantages

Interventional Nephrology: From Episodic to Coordinated Vascular Access Care

Fistula First - Overcoming Barriers

Pre-ESRD Fistula Care - Saving Vasculature