1st Interventional Nephrology

I am absolutely delighted to invite you all, my Fiji and Pacific medical and nursing colleagues, to the inaugural Interventional Nephrology Pacific Outreach 2025. The western pacific has the highest incidence of Diabetes globally, and consequently the highest number of Diabetes related deaths. The number of patients suffering from End Stage Kidney Disease, caused by Diabetes, and other non diabetic diseases, such as chronic glomerulonephritis, and autoimmune conditions like Lupus, continues to rise, with over 500 patients on long term dialysis in the pacific region, despite out of pocket expenses being a barrier to access. For all these patients, many only in their 3rd or 4th decade of life, without the opportunity to pursue kidney transplantation, good quality dialysis, and good vascular access literally translates to how long they will live.

Fiji has strived to pursue advances in healthcare in the region, supporting its Pacific family through training of doctors and nurses, as well as offering tertiary care not available in neighboring countries. Although sustainable hemodialysis treatment started in the early 2000s, it wasn’t until 10 years later, that we transitioned from temporary dialysis catheters to permanent catheters, significantly reducing blood stream infection rates. In the last 10 years further advances have happened with vascular access, with local surgeons acquiring the skills to create arteriovenous fistulas.

Through and following this first outreach visit, we hope to offer life-sustaining interventional procedures, including peripheral and central vein angioplasties needed to keep hemodialysis vascular access functioning optimally. In previous years we have tragically lost young patients as they ran out of vascular access options.

So, come join me and the phenomenal team of volunteers from Australia, to learn these advanced procedures that we once felt were unattainable for our region. May we continue to value all lives, including those who suffer from kidney failure. Every life, everywhere, matters.

Dr Amrish Krishnan

Nephrologist/ Interventional Nephrology Fellow