MANKATO — John Bishop was just doing routine household chores — taking out the trash — that day in 2006 when he tripped on the sidewalk.

The trip to the hospital that followed, however, ushered a new era of Bishop’s meaning of “routine.”

Since that hospital visit, and the discovery by doctors that his kidneys were failing, routine for Bishop means coming to Mayo Clinic Health System in Mankato several times each week for life-saving dialysis treatments.

“I’m here three days a week for four hours and 10 minutes,” said Bishop, seated comfortably in a dialysis chair Monday morning and watching “The Three Stooges” in a television mounted to the ceiling above him.

Bishop wasn’t alone. The room, with 16 dialysis chairs, was full of patients. And most of them have been outfitted with the preferred method of delivering dialysis treatments: arteriovenous fistula or AVF.

Patients diagnosed with end stage renal disease, or kidney failure, must have toxins filtered from their blood through the dialysis process. The easiest way to get this done is to have vascular surgeons create an artery-to-vein connection allowing increased blood flow to enlarge and strengthen the vein.

At Mayo Clinic Health System in Mankato and New Ulm, so many patients have upgraded from catheters to the AVF that the facility has been honored by the Centers for Medicare and Medicaid Services for its dialysis care in Mankato and New Ulm.

 The Centers for Medicare and Medicaid Services Fistula First initiative has the goal of using an AVF as the access point in at least 66 percent of all suitable patients.

And in 2011, 67 percent of suitable dialysis patients receiving treatments in Mankato and 77 percent of suitable patients receiving treatments in New Ulm were using AVF access points.  

“Exceeding CMS’ Fistula First goal demonstrates that our patients are receiving the best in world-class medicine from our integrated team of health care providers,” Fawad Qureshi, interventional nephrologist at Mayo Clinic Health System, said in a statement. “By creating an individualized plan of care for each of our dialysis patients, we are delivering the highest level of patient safety and service.”

 Qureshi said, in the past, area dialysis patients were referred to other facilities as far away as Rochester and the Twin Cities for additional appointments, including AVF surgeries and endovascular repair. That led to a delay in necessary care.

Now, though, patients in Mankato and New Ulm get the same level of care as patients in Rochester or the Twin Cities.

Qureshi said the trend in dialysis care around the world is to phase out the use of catheters. They are unsafe and can be easily dislodged, even by a well-meaning hug from a grandchild. They also make it nearly impossible for the patient to shower and can become infected.

“Catheters are really bad,” Qureshi said. “Poor quality of life, poor survival — they’re just bad.”

Bishop said his AVF makes his visits efficient and painless.

“I come in, they wash your arm, they weigh you, and then you let ‘em stick ya,” Bishop said.

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