Because it is big. Now is the era where chronic illnesses being the greatest healthcare problem, confronting both patients and any medical system. Demand for dialysis access is huge with the increasing prevalence of end stage renal disease ESRD worldwide. The demand further expands as life expectancy of many ESRD patients is improving resulting in longer dialysis life years. Dialysis access, plays a decisive role in the survival and quality of life of dialysis patients from months to decades. Not only the patients themselves but also their families are beneficiaries or victims of the dialysis access care. Dialysis access service also has big impact on
Because it is complex. Many consider dialysis access an easy subject. In fact, on the contrary, it is a very complex and sophisticated matter. Its complexity is in three dimensions. Firstly, dialysis access is neither a normal body condition nor a disease state. It is an abnormal access created to interact with the outside environment to achieve renal replacement therapy. Our understanding of the (patho)physiology of dialysis access is limited. The solutions to deal with problems of dialysis access are still in developmental stage. Secondly, patients requiring dialysis access are of a wide age spectrum, different social backgrounds, often with one or many medical co-morbidities. Thus, patients’ clinical needs and challenges may differ from one another tremendously. A good dialysis access strategy requires thorough evaluation and understanding of individual patient’s medical, anatomical, physiological and psycho-social status. Thirdly, the planning, creation, usage and maintenance of dialysis access involve a wide range of knowledge as well as skillsets that its span covers medical, surgical, nursing, imaging, interventional and more. There is no single healthcare expert or specialty that can provide all the services dialysis access requires. Good collaboration between the various healthcare professionals is needed but it is by no means easy to achieve.
Because it has been overlooked. Dialysis access service is one of the very deficient areas in healthcare despite the huge demands. Unfortunately, attention, training, resources and audit for dialysis access are lacking in most specialties involved. The overall outcomes are still unsatisfactory in both developing and developed countries. Different nations are facing their unique set of challenges in dialysis access. Furthermore, communication and close collaboration of various healthcare disciplines are rarely happening resulting in dis-coordination, and adverse outcomes.
It is a time for all of us who feel strongly for the ESRD patients and who share the passion to provide better dialysis access service to come together. The society can amplify the voices of our common concerns. It will form a platform for all members to share precious knowledge, concepts, ideations, experiences and skillsets about dialysis access. Members can obtain valuable resources for professional development from the society, but more importantly, contribute in many different ways to advance dialysis access services.
I look forward to your active participation and contribution at the SoDAS and let’s progress together.