News Release

Thursday, November 4, 2010

NIH videos help health providers answer questions about dialysis

First series focuses on arteriovenous (AV) fistula surgery.

Health care providers can now take advantage of a new video series to help them talk with patients about preparing for dialysis treatments, the National Institutes of Health announced today.

The eight short videos cover some of the most common questions patients ask about surgery to create an AV fistula, a connection between an artery and a vein in the arm that allows adequate blood flow for dialysis. The videos were produced by the NIH's National Kidney Disease Education Program (NKDEP) and the Fistula First Breakthrough Initiative (FFBI).

"We know that it is sometimes difficult for primary care providers to talk with patients about the different aspects of dialysis preparation," said Andrew S. Narva, M.D., NKDEP director. "We hope these videos will help providers feel more comfortable discussing fistula placement so those important conversations can happen earlier in the disease process."

A normal vein would not allow blood to flow rapidly enough to and from the dialysis machine, and repeated needle punctures would harm the vein. "We encourage patients to have a fistula placed in an arm several months before we anticipate they will need dialysis," Narva said. Advance placement allows time for the fistula to heal so it is ready for the first dialysis treatment.

"It is important for patients and their families to understand the need for permanent vascular access," said Brandy Vinson, FFBI project manager. "Fistulas provide such access, so we are pleased to have developed this video series with NKDEP. It helps us carry out our mission to meet patient and provider needs."

Each one- to two-minute video features Betty Garrison, an actual patient who is facing dialysis, and Narva, a board-certified nephrologist who answers her questions.

"Patients facing dialysis need to understand what is happening to them and to their bodies," said Garrison. "I was still a little fearful after talking with Dr. Narva, but I had my surgery because I knew it would help me in the long run. My fistula will be ready when I need to start dialysis."

The video series is featured on the websites of NKDEP and FFBI. To access the videos on the NKDEP site, visit the AV Fistula Placement section of www.nkdep.nih.gov/professionals/providereducation/index.htm. Find them on the FFBI site at www.fistulafirst.org/ProviderEducationalVideos.aspx.

NKDEP, an initiative of NIDDK, aims to improve early detection of kidney disease, help identify patients at risk for progression of kidney failure, and promote interventions to slow progression of kidney disease. For more information about NKDEP, see www.nkdep.nih.gov.

Fistula First Breakthrough Initiative Coalition members include the Centers for Medicare & Medicaid Services, Medicare ESRD Networks and a broad representation of other organizations from the renal community. The coalition works to ensure that every suitable hemodialysis patient will receive the optimal form of vascular access – in most cases, an AV fistula. The coalition focuses on reducing catheter use and vascular access complications to make hemodialysis safer, more effective and less expensive for all patients and insurers such as Medicare. Founded in 2003, the initiative is managed nationally by the Mid-Atlantic Renal Coalition, Midlothian, Va., which is the Medicare ESRD Network Organization for the District of Columbia, Maryland, Virginia, and West Virginia. Learn more about Fistula First at www.fistulafirst.org.

NIDDK, a component of the NIH, conducts and supports research in diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic, and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans. For more information about NIDDK and its programs, see www.niddk.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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