Dr Vinesh Padayachy, a leading vascular surgeon in South Africa, recently hosted a Renal Access Workshop at Coastlands Umhlanga to enhance renal care.

The timing of this event was intentional, aligning with Kidney Awareness Month to amplify its impact on raising awareness about kidney health and the importance of renal access management for patients undergoing dialysis.

"Kidney Awareness Month provides an opportune platform to highlight the importance of early detection, prevention, and management of kidney diseases."

“By holding the workshop during this period, we aimed to not only educate medical professionals but also bring public attention to the critical aspects of renal care,” explained Dr Padayachy, who practices at the Lenmed eThekwini Hospital and Heart Centre in Durban.

The workshop's agenda was meticulously crafted, offering a blend of practical knowledge and the latest advancements in renal access management.

From discussions on ultrasound-guided arteriovenous fistula (AVF) cannulation to strategies for alleviating needle fear in dialysis patients, the event covered a broad spectrum of topics aimed at improving patient outcomes.

Advancing Renal Access Techniques

A key focus of the workshop was the introduction of ultrasound-guided AVF cannulation as a potential new gold standard.

Traditional methods often rely on palpation and visual assessment, which can lead to a higher risk of complications such as infiltration or hematoma.

The ultrasound-guided technique, however, offers real-time visualisation of the vessel, enabling more accurate needle placement and reducing the likelihood of complications.

"This technique improves the accuracy and success rate of cannulation, reducing the risk of complications and improving the longevity of the access site.

"As more practitioners adopt this method, we can expect a shift towards more standardized use of ultrasound guidance in renal access procedures," said Dr Padayachy.

Another critical advancement discussed was the management of anticoagulation during dialysis for permanent catheters, AVFs, and AVG grafts.

Dr Padayachy highlighted the importance of maintaining catheter patency and preventing clotting to ensure the success of dialysis treatments.

Additionally, the workshop explored the latest techniques in catheter care and aseptic management, underlining the need for proper care to reduce infection risks and enhance patient outcomes.

Empowering Day-to-Day Practice

One of the workshop's primary objectives was to provide practical skills that medical professionals in attendance could immediately apply in their clinical settings.

By offering hands-on demonstrations and in-depth discussions, the event aimed to enhance the participants' ability to perform procedures like ultrasound-guided cannulation and anticoagulation management effectively.

"This direct application of knowledge is expected to lead to more successful renal access procedures, improved patient care, and reduced complications.

"The knowledge and skills shared during this workshop will undoubtedly contribute to better patient outcomes and the overall advancement of renal care practices," Dr Padayachy noted.

The Psychological Aspect of Dialysis Care

Recognising that the experience of dialysis extends beyond the physical procedure, the workshop also addressed the psychological aspects of patient care.

For many patients, needle fear can be a significant source of anxiety, potentially affecting their overall experience and compliance with treatment.

Dr Padayachy stressed the importance of compassionate care and patient education in easing this fear.

"Addressing the emotional well-being of patients is as crucial as the technical aspects of dialysis care.

"By discussing strategies to alleviate needle fear, we aim to improve the patient experience and foster a more holistic approach to care," he explained.

Navigating the Future of Dialysis Under NHI

A topic of significant interest during the workshop was the future of private dialysis units under South Africa's new National Health Insurance (NHI).

As the healthcare landscape evolves, medical professionals will need to adapt to a more integrated system, with potential changes in funding, patient access, and service delivery.

One of the key discussions of the day was led by health expert, Chris Maxon, who explored the future of private dialysis units under the new NHI.

Maxon who works at the Department of Health and who spoke in his personal capacity provided attendees with a forward-looking perspective on the potential changes and challenges that private dialysis units might face as the healthcare landscape evolves.

This topic was particularly relevant, given the ongoing discussions about healthcare reform in South Africa.

Maxon urged healthcare professionals to make their voices heard and to claim a “seat” at the table where decisions are being made about the future of healthcare in our country.

“There are a number of serious issues that still need your input such as the skill shortages and delivery models for the future

“Your role and input haven’t been solicited thus far and this will hamper prudent policy decisions,” Maxon told the audience.

Challenges and Opportunities Ahead

Also covered at the workshop was the implementation of new techniques like ultrasound-guided cannulation comes with its challenges, including the need for additional training and investment in equipment.

However, Dr Padayachy is optimistic that with comprehensive training and support, the adoption of these advancements can significantly improve patient outcomes.

"In the rapidly evolving field of renal care, continuous learning and adaptation are essential.

"By demonstrating the clear benefits of these techniques in improving patient outcomes, we can encourage wider adoption and integration into standard practice," he noted.

A Ripple Effect in Renal Care

The impact of the Renal Access Workshop extends beyond the event itself.

By empowering healthcare professionals with the latest advancements and best practices, the workshop contributes to the broader efforts of raising awareness and improving care for patients with kidney disease.

"As these professionals apply and disseminate this knowledge in their respective practices, they contribute to a broader understanding of the importance of kidney health and the need for early intervention and proper management," Dr Padayachy concluded.

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