Services
Glossary of Terms
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A
Access (or Dialysis Access)
Term given to the port of entry to the blood vessel which allows dialysis treatment to be delivered.
Advance Directives
Documents completed by a patient to note what can or cannot be medically done to, or for, them should they be unable to speak for themselves. A Living Will and a Medical Power of Attorney are different documents included in the term Advance Directives.
Allergies
Previous unexpected, negative physical reactions by patient to medication and/or food.
Anastomosis
The point where the surgeon connects the vein and the artery together, or to graft material, when creating a dialysis access.
Aneurysms
An abnormal enlargement of a blood vessel caused by weakening of the fistula walls after repeatedly placing dialysis needles in the same central location. It will look like a small balloon under the skin.
Angiogram
(Often used interchangeably with the terms fistulagram, arteriogram, and venogram.) A procedure involving the injection of contrast dye into a vessel followed by x-rays to identify problem areas in a fistula or graft. Always entered into the Cerner system during registration as an angioplasty because this is usually the end procedure performed.
Angioplasty
A procedure which involves introducing a balloon into the vessel and inflating it, thereby opening up a stenosed, or narrowed, portion of the vessel. Angiogram must be done in conjunction with angioplasty.
Arteriogram
(Often used interchangeably with the terms angiogram, venogram, and fistulagram.) A procedure involving the injection of contrast dye into a vessel followed by x-rays to identify problem areas in a fistula or graft.
Arteriovenous (AV)
Connection between an artery and a vein.
B
Blood Flow Rate (BFR)
Term used to describe how fast blood can be pumped by the dialysis machine during a dialysis treatment. If a patient has a decreased BFR, it means that the speed is being restricted during dialysis treatment which can be due to problems with the access.
C
C-Arm
An x-ray machine used during vascular access procedures that can be rolled into place to take pictures while a procedure is underway. The machinery is shaped like a letter “C” with one end sliding over the patient, while the lower portion slides under them.
Catheter Exchange
A procedure performed at our center which entails the removal of a problem hemodialysis catheter and the placement of a new one.
Catheter Removal
Catheter is removed when a patient has a usable permanent access for dialysis
Check-In
Process whereby patient is noted in the computer system as being in the clinic and either waiting for, or receiving, treatment. (Patients are never “Checked Out” in the computer. Nurses will close out a patient designating the patient is finished in the clinic.)
Clotted Access
Dialysis access that has no flow and is unable to support the dialysis process.
Conscious Sedation
(Moderate Sedation) medication given to a patient during a procedure that keeps them relaxed, sleepy, but able to respond to commands or questions, i.e., Versed.
Contrast
Radioactive dye used during access procedures to makes vessels viewable under x-ray. It is important to know if patient has a contrast allergy prior to scheduling procedure.
Crash Cart
Red cart containing medication and equipment for medical emergencies.
D
Dialysis
A means of removing toxins and excess fluid from the body after the kidneys have failed to function. Once a patient’s kidneys have failed, it is impossible for the patient’s body to sustain life without regular dialysis treatments.
Dialysis Days & Time
Dialysis patients generally receive dialysis three times per week on set days and times, i.e., Monday / Wednesday / Friday (MWF) or Tuesday / Thursday / Saturday (TTS). Dialysis centers schedule patients for distinct shifts, generally morning which begins around 6:00 am, afternoon which begins around 11:00 am, and evening which begins around 4:00 pm. Knowing when a patient dialyzes, i.e. MWF-11:00, allows you to schedule a patient’s access procedures at a time that will not interfere with his or her life-sustaining dialysis treatments.
Discharge Instructions
Copy of the instructions given to patient regarding procedure done at the center.
Dry
(EDW -estimated dry weight) Term used to describe the weight of a dialysis patient who has excess fluid removed.
E
Elective Procedure
A clinical procedure done on a non-emergency basis which can be scheduled at the next available open appointment, i.e., angiogram, angioplasty, catheter removal, vein mapping.
Embolization
The placement of a coil in a vessel to clot it off. This is done to small vessels branching off a fistula.
Emergency Procedure
A non-elective procedure done when a patient does not have a functioning access to allow dialysis to be delivered, i.e. catheter exchange, catheter placement, thrombectomy. The procedure needs to be scheduled as soon as possible since patient cannot receive life-sustaining treatment.
Extremity Vein Mapping
Also referred to as vein mapping, this procedure is done prior to placement of a permanent vascular assess. It generally utilizes ultrasound and x-ray to visualize veins and arteries to allow for optimal placement of a permanent vascular access. The information gleaned is then sent on to the vascular surgeon for utilization in the access placement procedure.
F
Fistula
A dialysis access created with a patient’s native vein and artery to allow for increased blood flow for hemodialysis treatment. This is one of the two permanent vascular accesses seen and maintained at our center. We do not place AV fistulas, we only maintain them. AV fistulas cannot be used for dialysis treatment immediately after placement and take longer to mature than AV grafts. They are the preferred means of hemodialysis access. These need to be evaluated usually by 6 weeks after creation.
Fistulgram
Often used interchangeably with the terms angiogram, venogram, and arteriogram.) A procedure involving the injection of contrast dye into a vessel followed by x-rays to identify problem areas in a fistula or graft.
G
Graft
An artificial material surgically implanted between an artery and a vein to create an access and allow delivery of hemodialysis. This is one of the two permanent vascular accesses seen and maintained at our center. We do not place AV grafts, we only maintain them. AV grafts cannot be used for dialysis treatment immediately after placement. These can usually be used within 2-3 weeks.
H
Hemodialysis (Dialysis)
A type of dialysis that removes toxins and excess fluid from the body by continuously removing small amounts of blood and filtering it before returning it to the body. This type of dialysis is usually done in a dialysis center and generally requires three treatments per week with each treatment lasting three to five hours. This type of dialysis utilizes the vascular system and requires periodic intervention at an access center to keep it functioning optimally.
Hemodialysis Catheter
This dialysis access involves placing a tube into a large vein and is most often placed in the upper chest, but can be in the thigh area. Unlike grafts or fistulas, catheters can be used immediately, allowing time for a permanent access to be placed and mature. Catheters carry a high risk of infection. There are 2 types of catheters: (1) long term catheters, which are tunneled under the skin; and (2) short term catheters which are temporary and should be used only 2 weeks.
High Venous Pressure
A condition caused by restricted blood flow in a dialysis access. The dialysis machine pumps the returning blood into the access, but the machine alarms when the blood flow is restricted due to a narrowing in the vessel. This, in turn, causes back pressure due to the vessel’s inability to send the blood through the vessel at the same rate in which it is entering. A patient with high venous pressure may have difficulty with prolonged bleeding after treatment. (Think of a kinked garden hose with a hole in it between the kink and the faucet.)
I
Initial Catheter Placement
Placement of hemodialysis catheter necessitated by a need for dialysis when a functioning fistula or graft is not present.
Interventional Nephrologists
Physicians trained in nephrology and in performing procedures to correct problems with dialysis accesses.
L
Lifesite
A type of hemodialysis access in which a device is surgically implanted under the skin to allow access to large veins. Accessed with special needles through the skin.
Living Will
A form of advance directive. This document is written by a patient ahead of time specifying what can or cannot be done to him or her, medically speaking, should they be unable to speak for themselves, i.e., no life support, tube feeding, cardiac resuscitation, etc. The dialysis center social worker can assist them should they wish to complete this document.
Local Sedation
Sedation given during a procedure that only numbs the immediate work area, i.e. Lidocaine.
M
Medical Power of Attorney
A form of Advance Directive. This document is completed by patients in advance of need, and specifies a particular person or persons authorized to make medical decisions for them should they be unable to make decisions for themselves.
MSDS (Material Data Safety Sheet)
A document prepared by a chemical’s manufacturer which tells a consumer what risks are associated with a chemical and how to use it safely.
N
Nephrologist
An internal medicine physician who specializes in the treatment of kidney disease.
Non-Invasive
Not penetrating the skin.
No-Show
Patient does not show up for a scheduled appointment. (Patient cannot be put into computer system as a no-show until the physician has left the building.)
NPO
Nothing by mouth.
O
Overloaded (Fluid Overloaded)
Term used to describe the condition of a dialysis patient who has too much fluid in his body and has not had adequate dialysis to relieve the fluid stockpile. Fluid overload has a very negative effect on the patient’s health and comfort level.
P
Peritoneal Dialysis (PD)
A type of dialysis that removes toxins and excess fluid from the body using the (abdominal cavity) peritoneal cavity and membrane as a filtering system. Peritoneal dialysis is performed daily in the patient’s home.
Poor Labs
Labs are drawn on a dialysis patient monthly or when problems are suspected. Labs would be termed poor if toxins are not being removed at an adequate rate during the dialysis process.
Pseudo-aneurysm
Bulge or ballooning in a graft caused by a weakening of the graft’s synthetic material which can be caused by dialysis needles being placed repeatedly in the same site.
R
Referral
This term is used in two different ways at our center. First, a clinic referral form is used as a means of requesting access intervention. We request that physicians or dialysis centers complete a referral form when sending a patient to us so we know what kind of access the patient has, what the problems are, and what their nephrologist would like done to correct them. The referral form also gives us general patient information so we can get the patient scheduled and put into our database. An insurance referral, on the other hand, is obtained for patients with HMO insurance and is obtained from the patient’s primary care physician. This document gives us permission to see a patient and allows us to be paid.
RN
Registered Nurse
RT
Radiology Technologist
Run Time
Dialysis term used to describe how long a patient has to run on the dialysis machine, or the length of his prescribed treatment.
S
Stenosis
A narrowing in a vessel that restricts blood flow, slowing down the dialysis process and making it less efficient in cleaning the blood.
Stent
Metal mesh device placed in a vessel that doesn’t respond well to angioplasty. The device will reinforce the area to keep it open.
T
Thrombectomy
An access procedure commonly called a Declot, because blood clots are removed from a patient’s access allowing for a renewed blood flow and adequate dialysis treatment.
Transportation Policy
Specific procedure to be followed when it is necessary for the access center to provide patient transportation. Transportation cannot be offered prior to an appointment being made and cannot be used as inducement for a patient to come to our center.
U
Ultrasound
Equipment used for non-invasive viewing of vessels.
V
Vascular
Related to the arteries or veins.
Vein Mapping
Also referred to as extremity vein mapping, this procedure is done prior to placement of a permanent vascular assess. It generally utilizes ultrasound and x-ray to visualize veins and arteries to allow for optimal placement of a permanent vascular access. The information gleaned is then sent on to the vascular surgeon for utilization in the access placement procedure.
Venogram
(Often used interchangeably with the terms fistulagram, angiogram, and arteriogram.) A procedure involving the injection of contrast dye into a vessel followed by x-rays to identify problem areas in a fistula or graft.
