Plasma Concentration of Galanin in Chronic Hemodialysis Patients

Abstract

The field of Interventional Nephrology needs to be viewed as a new road towards improving the dialysis access care provided to chronic kidney disease patients across the globe. Dialysis access remains a weak link and a major hurdle both in the planning and maintenance phase of renal replacement therapy. Traditionally the nephrologist has assumed the role of a “thinker” and delegated the procedural aspect of care to surgeons for access creation and radiologists for access maintenance procedures. As a result the dialysis access care is treated like a step-child. The end result of such a fragmented care leads to patient inconvenience and high healthcare cost to the society. The nephrologist is ideally suited to understand the complexities involved with renal replacement therapy. The advent of Interventional Nephrology in the United States has created a new opportunity for the nephrologists to change their roles from “thinkers” to “doers” and “leaders”. The subspecialty is a step towards not only learning the necessary skills to perform dialysis access related procedures but to assume a leadership role in coordinating a team to provide the best possible care. The subspecialty received a further boost with the establishment of the American Society of Diagnostic and Interventional Nephrology (www.ASDIN.org) in 2000. Over the past decade, the society has succeeded in convincing the medical community about the role of a nephrologist as an interventionalist in learning the skills and performing procedures such as – fistulograms, percutaneous balloon angioplasty, thrombectomies, coil and stent placements, tunneled catheter placements, renal ultrasounds, peritoneal dialysis catheter placements, renal arteriograms and renal biopsies. As a leader the interventional nephrologist can coordinate with the dialysis staff and patients as well as with the