I am Namrata Krishnan and I am a nephrologist at the Yale School of Medicine and Veterans Affairs Medical Center in CT. The goal of this module is to teach you clinical skills to evaluate hemodialysis access function and malfunction.

The module has 3 main sections

  • Section one is directed to concept learning and covering the basics of AV access creation and functioning, physical examination of an av access, and access stenosis.
  • Section two contains interactive patient videos and images to highlight some key learning points around dialysis access.
  • Section three is made up of five of simulated cases around some common clinical scenarios encountered in the dialysis unit related to access malfunction.

In this module, you will learn how to

  • Evaluate when a fistula is ready by using The Rule of 6.0s
  • List and identify three common fistula sites
  • Conduct a physical exam to look, feel, listen and conduct three simple bedside tests
  • Identify 3 types of stenosis and how they present based on patient symptoms, physical exam, dialysis machine readings.
  • Review some other common complications besides access stenosis of an AV access.
  • Briefly review key findings on diagnostic tests (Ultrasounds/Fistulograms) and understand treatment of access complications.

Special Thanks

I would like to thank Dr. Gunabushanam, Interventional Radiologist at The Yale School of Medicine for his contribution to the module and Belinda Platt at the Yale Center for Teaching and Learning for her valuable help with digital animation and web designing. Finally, I’m very grateful to the ASN for giving me the opportunity to present this work to the ASN innovations in kidney education contest 2018.