Nephrology and Hypertension

Comprehensive renal replacement therapy (dialysis) options are available to people with chronic kidney disease. Dialysis services are offered at the Mayo Clinic campuses in Florida, Minnesota and several communities throughout the Mayo Clinic Health System. Mayo Clinic has provided dialysis services for more than 65 years.

The dialysis centers help people with kidney disease or kidney failure by offering:

• Chronic Kidney Disease (Renal Failure) Clinic, where a dedicated team of providers work together to provide comprehensive care to people with kidney disorders
• Home dialysis training and support for both home hemodialysis and peritoneal dialysis
• In-center hemodialysis
• Outpatient dialysis services
• Preemptive kidney transplantation evaluation
• Nutrition counseling, for people who need ongoing guidance from dietitians with expertise in kidney disorders, provides ongoing guidance for nutritional needs
• Temporary dialysis if you need treatment while traveling

The dialysis centers feature an effective staff-to-patient ratio. Staff members include registered nurses, certified chronic hemodialysis technicians, a renal dietitian and a renal social worker, all under the direction of a dedicated medical director.

Your treatment team holds monthly care conferences with you to ensure your needs are being met. Your family members are welcome at these meetings.

When you undergo dialysis at Mayo Clinic, your treatment is managed by specially trained nurses. If you're developing end-stage renal disease, you may be treated in an outpatient dialysis center, which offers both in-center and at-home training for dialysis.

Dialysis services at Mayo Clinic in Florida

Mayo Clinic Dialysis Center map

The dialysis center is located on Mayo Clinic's West campus at 4658 Worrall Way, Jacksonville, Florida. A shuttle service from the Mayo Clinic Dialysis Center to the Davis Building is available for people who have same-day appointments at the Jacksonville campus of Mayo Clinic.

The Dialysis Center on Mayo Clinic's campus in Jacksonville, Florida, is nationally recognized for its high-quality patient care. It has a five-star rating from the Centers for Medicare & Medicaid Services (CMS). A five-star rating from CMS means much above average compared with other dialysis facilities.

• Patient-centered facilities. The center offers 24 private dialysis stations, three home-training rooms, two exams rooms and a centrally located nursing station. The design of the unit is intended to give you quiet space and the feeling of being in a private room, while allowing your care team to observe your dialysis session from the nursing station. In addition, online monitoring allows staff to follow your progress throughout the treatment.
• Collaboration to drive better patient outcomes. The Dialysis Center in Jacksonville, Florida, will be the home to a new renal care center of excellence being developed in collaboration with Baxter International Inc. Together they are developing a chronic kidney disease program focused on slowing the progression of kidney disease. They are also developing Baxter's latest technologies to support the clinical and lifestyle needs of people with kidney disease.
• Home training program.A specially designed training area includes a bedroom with a shower and toilet facilities. A nephrologist oversees the training program, which is managed by an experienced home dialysis training nurse. The program is designed for people who desire more independence and control over their treatment options. If you're trained to perform your dialysis at home, you'll return to the center once a month for evaluation.

When you undergo dialysis at Mayo Clinic, your treatment will be managed by specially trained nurses. If you're developing end-stage renal disease, you may be treated in an outpatient dialysis center, which offers both in-center and at-home training for dialysis.

Hemodialysis vascular access

Undergoing chronic hemodialysis requires an easy access to your bloodstream, which is achieved:

• Through the blood vessels (called an arteriovenous fistula)
• By inserting a tube made from synthetic material that links an artery and a vein under the skin — a polytetrafluoroethylene (PTFE) graft
• By inserting a catheter in a vein (a venous catheter)

The right hemodialysis vascular access must be individualized for each person. A vascular access is created by a surgeon in an operating room. You will likely be given a local anesthetic or general anesthesia. The vascular access (fistula or graft) is usually placed in the arm and often requires several weeks or months to heal and be ready for use. The vascular access may be noticeable to other people. This vascular access is your lifeline, and special care is necessary to make sure that it continues to function properly. A catheter is usually placed in the neck and may be placed by a vascular surgeon or an interventional radiologist.

Our vascular surgeons are skilled and experienced in creating all types of vascular access and are leaders in vascular access innovation. Mayo's interventional radiologists are experts in imaging and declotting and opening the vascular access. Interventional radiologists also insert dialysis catheters. Vascular surgeons, interventional radiologists and nephrologists work together to provide quality access care.

During your dialysis treatment, you'll be checked regularly to make sure your hemodialysis access is working properly. This part of the process helps minimize unexpected malfunctions or clotting. Vascular surgeons and interventional radiologists are available to help insert new hemodialysis access devices, revise old access devices to maintain their function, and help to declot and repair fistulas or grafts.

Your dialysis care team

• Nephrologist. A nephrologist is a doctor who has completed three years of internal medicine training and an additional two to three years of specialized training in nephrology (study of kidney diseases). The nephrologist provides ongoing care for all kidney-related problems and general medical problems for people who regularly undergo dialysis. A nephrologist visits the dialysis unit on a regular basis to review patients' medical problems and test results. A nephrologist also sees each patient annually for a comprehensive exam.
• Dialysis nurses and patient care technicians. Dialysis nurses are registered nurses who have received additional training on the medical needs of people who undergo dialysis regularly. They help provide hemodialysis in the center; train patients for self-care hemodialysis, home hemodialysis and peritoneal dialysis; visit with patients at each hemodialysis treatment; and provide ongoing care, along with the nephrologist and nurse practitioner. The nurses teach people about their kidney disease, medical problems and chronic dialysis. Patient care technicians help the nurses with inserting needles into the hemodialysis access and monitor the hemodialysis equipment for safety. Nurses and patient care technicians provide emotional and psychological support and work with people to help them adapt to chronic kidney failure.
• Renal dietitian. A registered dietitian trained to care for people with kidney disease is an integral part of the health care team. The dietitian sees all patients regularly. People with chronic kidney failure have special nutritional needs and require ongoing education about how many calories and how much protein, fluids, sodium, potassium and phosphorus they can take in.
• Social worker. A medical condition such as kidney failure places a great deal of emotional stress on the people affected and their loved ones. Mayo Clinic social workers help provide emotional support. They are also knowledgeable about the financial implications of chronic kidney failure and are excellent resources for financial questions, delivery of in-home services, job retraining, physical therapy and rehabilitation.
• Dialysis technical staff. Dialysis technicians provide preventive maintenance and repair hemodialysis equipment. They are also responsible for dialyzer (artificial kidney) resterilization and help maintain the safety and purity of the water that is used for hemodialysis. Members of this staff also help people on peritoneal dialysis and home hemodialysis obtain the proper equipment and supplies.

Transient dialysis support

People on dialysis are usually seen for a brief review of their dialysis program and active medical problems. To request transient dialysis support, call the Mayo Clinic Dialysis Center. The Mayo staff will want to talk to the nursing staff in your current dialysis facility.

The following information will be requested:

• Patient name, date of birth, Social Security number
• Dates patient expects to be in Jacksonville
• Cause of renal failure
• Current dialysis treatment orders
• Access information
• Known allergies
• Information regarding patient stability
• Information regarding infection precaution
• Ongoing pertinent medical problems
• Recent history and physical

People on peritoneal dialysis must arrange for the peritoneal dialysis supplies before coming to a dialysis center.

Mayo Clinic Outpatient Dialysis Center staff help people arrange for an appointment with a Mayo Clinic nephrologist.