These patients are often admitted as inpatients under the nephrology service or attend the renal day ward. Where they are admitted under vascular surgery directly, they will need to be fully worked up.
- History and examination
- Inform the renal team that the patient has been admitted and check re dialysis schedule. Ideally, the patient should be dialysed the day before the surgery and all thier post dialysis bloods checked that evening.
- Check which side and site is planned, document this in the notes and record on the consent form. You should mark the appropriate side/arm at the time of getting the form signed.
- The risks of the procedure incluidng failure, nerve injury, steal syndrome (which may require reversal) should be explained to the patient.
- The procedure is usually performed under local anaesthesia.
- Perioperative fluid management is usually in consultation with the nephrology team