The field of dialysis access and its complications has become huge over the past
decade. According to the last count in 1998, it is estimated that over 300,000
patients in the United States are on some form of dialysis—hemodialysis in 60%
of these patients, renal transplants in approximately 25%, and peritoneal dialysis
in 9%. The cost of revising failed or failing dialysis access graft exceeds $500
million per year. Strategic planning with subsequent publication by the National
Kidney Foundation Dialysis Outcomes Quality Initiatives (NKF-DOQI)–Clinical
Practice Guidelines for Vascular Access has made the art of doing procedures
on these patients into a science with expected plans of attack and outcomes.
Overall, I think this is a good thing.