JAI RADHAKRISHNAN, MD: By trial and error, we came to know that we need about only 10% to 15% of kidney function. Certainly below 10%, most patients do feel the effects of not having adequate kidney function, and approximately thereabouts, we start the dialysis procedure.
LISA CLARK: Now, there are several types of dialysis -- peritoneal dialysis, and there's hemodialysis. For the purposes of this segment, we're going to focus on hemodialysis, which is a specialty of yours, so I'll ask you to begin with a brief explanation of the process. What happens when someone goes in for dialysis?
JAI RADHAKRISHNAN, MD: Hemodialysis essentially means cleaning the blood, and hemodialysis is a process whereby a machine which takes over part of the kidney function takes a large volume of blood from the patient, processes it the way the kidneys would normally process it, get rid of the waste and return the blood washed, in a manner of speaking, back to the patient. So when a patient who is supposed to be dialyzed comes to our unit, for example, you would sit in a chair, the nurse would put a needle into a special vein, which is surgically created, called a fistula. The two needles are connected to a machine, which then runs through the treatment time, which is about four hours. At the end of the treatment, the patient basically disconnects from the machine and is able to go home.
LISA CLARK: Len, is the fistula a permanent access site for hemodialysis?