Interventional Nephrology is a subspecialty of nephrology focusing on performing diagnostic and therapeutic procedures to manage kidney diseases and associated complications. It bridges nephrology with interventional techniques to improve patient outcomes, particularly for those requiring renal replacement therapies or complex vascular access.

Interventional nephrologists receive specialized training in:

• Vascular access management.
• Imaging techniques.
• Procedural skills like angioplasty and biopsies.

Key Procedures in Interventional Nephrology

1. Vascular Access for Dialysis.

Arteriovenous (AV) Fistula Creation:

• Surgical connection of an artery and vein to create durable access for hemodialysis.
• Preferred method due to its longevity and lower infection risk.

AV Graft Placement:

• Synthetic tube connects arteries and veins when fistulas are not feasible.
• Suitable for patients with poor vascular anatomy
• Central Venous Catheter (CVC) Placement:
• Temporary access for urgent hemodialysis.
• Common sites: Internal jugular, subclavian, or femoral veins.

Catheter-Related Interventions:

• Removal of infected catheters.
• Thrombolysis to restore catheter potency.

2. Imaging-Guided Interventions

Ultrasound-Guided Procedures:

• Placement of dialysis catheters.
• Assessment of AV fistulas and grafts.

Fistulography:

• X-ray imaging to evaluate the potency of AV fistulas or grafts.
• Identifies stenosis, thrombosis, or other complications.

Angioplasty and Stenting:

• Performed to treat stenosis in dialysis access or renal arteries.
• Maintains or restores blood flow.

3. Dialysis-Related Interventions.

Peritoneal Dialysis Catheter Placement:

• Insertion of a catheter into the peritoneal cavity for peritoneal dialysis.
• It can be done surgically or via percutaneous techniques.

Peritoneal Dialysis Catheter Management:

• Catheter replacement for malfunction or infection.
• Revision procedures to restore catheter function.
• 4. Kidney Biopsy
  Performed under ultrasound or CT guidance.
• Used to diagnose glomerular diseases, nephrotic syndrome, acute kidney injury of unknown cause, and post-kidney transplant allograft dysfunction.