Amongst all interventions taken up by Nephrologists, AVF is the most gratifying but the least practiced. The intimidating reasons for this sluggish take off are, AVF creation involves ‘cutting & suturing’ which are perceived to be surgeons’ domain and the demotivating sights of failing AVFs created by even ‘vascular surgeons’. But in reality, it is very much possible for a nephrologist to acquire enough skills to create functioning and long lasting AVFs. This has been time and again proven from data, especially from Indian Nephrologists. Although Initially AVF was attempted by nephrologist out of sheer necessity, now we seem to have more reasons to include AVF creation in day to day practice of passionate Interventional Nephrologists, if not all. Of course this cannot be learnt by simply attending meetings or seeing YouTubes – one needs to work hard with perseverance under supervision to get trained. If only teaching institutions manage to include this in the curriculum, more Nephrologists would be creating AVFs.

Last INForm meeting was held on 25th, September. Theme of the meeting was AVF creation by nephrologist. Padmashri Dr. D.S. Rana, the guest of honour and a panellist, in his opening remarks talked about the history of beginning of AVF creation by nephrologist in this country from his own experience. It was a great motivational talk for the youngsters. Dr.Sachin Soni from Aurangabad and Dr. Vel Aravind from Trichy, noted Interventional Nephrologists with vast experience in AV Fistula creation were the other panelists.

Dr Shailendra Shresta from Biratnagar, Nepal made a video presentation of AVF creation techniques. It was notable that he took pains to learn AVF creation after his DM course by spending months in different centres. He demonstrated end to side and side to side anastomosis in both radio cephalic and brachiocephalic areas.

Learning and getting trained in interventional Nephrology is one thing and getting it practised in an institution is another thing. This was brought out by Dr. Venkatramanan in his talk on ‘Travails of an aspiring interventional Nephrologist’, where he described the hardships he had to undergo before convincing the hospital administration to get around the obstacles posed by other specialists.

This was followed by a an interesting and down to earth talk on ‘Skills beyond boundaries…’ by Dr Joseph Sathianathan,  vascular surgeon from UK, our special guest speaker. His views from a surgeons perspective gave an interesting angle, hitherto not realized by us, to our outlook and endeavour to become Interventional Nephrologists.

Dr Athul Thomas from CMC Vellore gave a very useful demonstration of safe peritoneal puncture using Veres needle and the data from CMC. Following the talks there was active panel discussion by the panellists and interesting comments chipped in by Dr Adrian, Dr Vijay, Dr Narayan Prasad, and many others.

The video recordings of the meeting is available in our website.