ASDIN and VASA Issue Joint Statement - Maintaining Lifelines for ESKD Patients

March 24, 2020

In response to the COVID-19 pandemic, the American Society of Diagnostic and Interventional Nephrology (ASDIN) and the Vascular Access Society of the Americas (VASA) have issued a joint statement. Please click here to read the joint statement document.

"The Covid19 pandemic is presenting the world with an uncertain future. In the US we do not know if epidemiological disease trajectories will follow the course of many European countries, if there will be a 40-50 days sharp peak in new infection, a many months long flattened curve, or two peaks, one now followed by one in the fall.

Infection rates and patterns of disease severity manifestations indicate that in-patient care will face extreme challenges, including possible lack of ICU beds, ventilators, PPE (personal protective equipment), nursing and physician staff, to name a few. In light of the need to conserve critical resources CMS published recommendations for adult elective surgeries on March 18, 2020 (https://www.cms.gov/files/document/31820-cms-adult-elective-surgery-and-procedures-recommendations.pdf).

Dialysis accesses, including fistulas, grafts, PD and hemodialysis catheters are the lifeline for patients with end-stage kidney disease. While access dysfunction does not result in immediate death, lack of dialysis access will lead to major complications and eventual demise, usually over the course of days to weeks.

Procedures performed to maintain functional dialysis access patency or to transition a tunneled dialysis catheter dependent patient to a different long-term access options reduce overall morbidity and mortality. As the functional deterioration of dialysis access is usually rapid over days to weeks, a timely intervention would avoid replacing short duration, low intensity, high success procedures (e.g. angioplasty or stent placement) early with longer duration, higher intensity, higher failure procedures (e.g. thrombectomy or surgical revision) later." ...
Please click here to read the complete joint statement document.

The document also includes three appendices: 1) Triage Process for Endovascular Procedures, 2) Open HD Access Cases Performance Plan, and 3) Procedure Names and Usual CPT Codes.

Please share this document widely with your colleagues.