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Renal Institute, Kidney Clinic Dr Ali Nayer, Miami FL
Renal Institute, Kidney Clinic Dr Ali Nayer, Miami FL
Hemodialysis is a method of cleansing blood using an artificial kidney (dialysis) machine. A vascular access is a way to reach blood for the dialysis procedure. For proper cleansing, blood has to travel through the dialysis machine at high flow. This is best achieved by using an arterio-venous (AV) fistula. An AV fistula is a vascular access made by joining an artery and vein. The high pressure of the arterial blood flow causes the vein to enlarge and thicken (a process known as maturation). Once an AV fistula is mature, two needles are placed in the fistula to draw and return blood. The process is similar to putting two iv's in a vein, and therefore it can be performed by a nurse at a dialysis center. Creation of an AV fistula requires a specialized operation that is usually performed by a vascular surgeon.

The specialists at the Miami Renal institute work with Marwan Tabbara, M.D., an experienced vascular surgeon at the Division of Vascular Surgery at the University of Miami Miller School of Medicine. Dr. Tabbara is an associate professor of surgery and in charge of the Vascular Access Program and the Non-Invasive Vascular Laboratory at the University of Miami Hospital. Dr. Tabbara has published extensively on dialysis vascular access and has given lectures at medical centers across the United States.

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Did You Know, by Renal Institute, Kidney Clinic Dr Ali Nayer, Miami FL
Publications

Tabbara M, Duque JC, Martinez L et al. Pre-existing and Postoperative Intimal Hyperplasia and Arteriovenous Fistula Outcomes. American Journal of Kidney Diseases. 2016 Sep;68(3):455-64

Goldstein LJ, Balabanoff C, Carillo R, de Mendoza VL, Bornak A, Tabbara M. Minimally invasive axillary to right atrial graft for hemodialysis access utilizing the intraluminal flow guard graft. Journal of Vascular Access. 2015 Sep 29;16(5):e87-8

Allan BJ, Perez ER, Tabbara M. Analysis of 855 upper extremity fistulas created using a standard protocol: the role of graft extension to achieve functional status. The American Surgeon. 2013 Jun;79(6):625-9

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Did You Know, by Renal Institute, Kidney Clinic Dr Ali Nayer, Miami FL
Renal Institute, Kidney Clinic Dr Ali Nayer, Miami FL
Kidney Pathology

Diagnosis of kidney disease is based on a person's signs and symptoms, laboratory tests, and imaging studies. However, a kidney biopsy may be needed in special circumstances.

A kidney biopsy is a procedure carried out to obtain a tiny piece of kidney tissue for examination under a microscope.

A kidney biopsy is often needed when a diagnosis cannot be made with certainty on the clinical grounds. A kidney biopsy also helps to establish the severity of kidney disease.

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Renal Institute, Kidney Clinic Dr Ali Nayer, Miami FL
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