NephrologyPhysiciansLocations

Our Dialysis Access Center

Located in Newington, our Access Center provides a private, outpatient setting where we can evaluate and treat common problems associated with the catheters, grafts, and fistulas necessary for dialysis access.

At our Access Center, board-certified nephrologists specializing in interventional nephrology are skilled in diagnostic and therapeutic AV shunt procedures, in addition to the insertion, replacement, or removal of central venous catheters.

Below are some common testing and treatment techniques:

• Angiography: With sophisticated equipment, our physicians are able to examine blood flow through the dialysis access and identify whether there are any obstructions or narrowing in the blood vessels.
• Angioplasty: If there is a narrowing, or stenosis, a catheter may be used and a balloon inserted to open up the vessel to optimize blood flow.
• Stent: Should the vessel not open completely or become weakened, a stent can be transported through the catheter as well.
• Thrombectomy: If there is a collection of blood or blood clot blocking or reducing the flow, a balloon and/or a special medicine can be delivered through a catheter to help destroy the clot.
• Embolization: Sometimes there are extra vessels that develop and divert blood flow away from the graft or fistula; when this happens, tiny coils may be deployed through the catheter to close off the accessory veins.

All of these procedures are performed percutaneously, or through the skin, which means that there are no incisions or sutures required. Also, local sedation will be administered to ensure that each patient is comfortable throughout the treatment.

Click here to meet two of our transplant and surgical specialists.

Our Access Center team shares their approach to care and how they make a positive difference in the lives of dialysis patients. 

505 Willard Ave, Building 1
Newington, CT
Phone: (860) 665-7070
Fax: (860) 665-8080

High blood pressure, also known as hypertension, is a serious condition. Left untreated, hypertension can put you at risk for stroke, heart attack, and damage to vital organs including the kidneys. Getting an accurate assessment of blood pressure is critical. New guidelines recommend a reading of 120/80 or less for most Americans.

While blood pressure reading can be taken in a physician’s office, results can sometimes be misleading. That is why Starling is proud to offer a 24-hour ambulatory blood pressure monitoring system. This allows us to measure your blood pressure on a continuous basis in the comfort of your home. 

About Ambulatory Blood Pressure Monitoring (ABPM)

ABPM uses a small digital blood pressure machine that is attached to a belt around your body and connected to a cuff around your upper arm. It small enough that you can go about your normal daily life, and you can even sleep with it on. It enables the monitoring of many blood pressure (BP) readings to be recorded over a 24-hour period. Readings are taken every 30 minutes during the day and every hour at night.

The machine is returned to our office after a 24-hour period. We are then able to analyze the data and trends, which enables us to make informed decisions about the most effective treatment options.  

Benefits of Ambulatory Monitoring

By measuring your blood pressure at regular intervals over 24 hours, we are able to get a clear picture of how your blood pressure changes throughout the day and night.

There are a number of reasons why your Starling provider may suggest this test:

• Assess if high blood pressure readings in the office are higher than they are away from the office – called the “white coat effect.”  White coat hypertension has been observed in as many as 20% of patients with elevated BP readings. When ambulatory monitoring yields readings within the normal range, patients usually do not need to take antihypertensive drugs.
• Ensure that you do not have masked hypertension which is a condition that occurs when your BP reading is normal at the doctor’s office, but is elevated at home.  
• Diagnose and manage sustained hypertension which refers to BP readings that are elevated whether you are in the doctor’s office or at home. This condition has been linked to an increased likelihood of heart and kidney damage.
• Evaluate how well your medicines are working and whether they are controlling your blood pressure throughout the day and night. This allows us to tailor your drug regimen based on your individual needs. 

Note: Insurance will often cover the cost when white coat hypertension is suspected. Please talk with your doctor and check with your insurance provider prior to ambulatory monitoring.

Enabling Us to Provide The Highest Level of Care

Ambulatory monitoring provides critical information to help us get an accurate and comprehensive assessment of your risk of hypertension. This ensures that you are not given prescriptions for BP-lowering drugs if they are not needed. It helps us detect when intervention is necessary to reduce risk factors. And, this information ensures that your medications are achieving their desired effect and can be optimally managed.

What To Expect With the Blood Pressure Monitor

At your appointment, your doctor will provide you with the ambulatory monitor and instructions on usage. Here are some things to keep in mind:

• The monitor will not display any blood pressure readings.
• The monitor will go off every ½ hour during the day, and every hour after 9:30 or 10:00 pm. You may remove the unit to shower or change clothes as needed. If a reading is missed, please inform the office when returning the unit. It is important that the unit remain on for 24 hours for maximum blood pressure accuracy.
• Your will hear a beep and then a 5-second countdown prior to the cuff pumping.
• When the blood pressure unit starts to pump, keep your arm very still and elevated (approximately shoulder height). You can rest it on a surface for stability.
• There is a ½ hour between readings, so you may remove the monitor to shower or change clothes.
• Place blood pressure cuff back on the arm, snuggled above the elbow.

Please return the blood pressure monitor to our office the next business day by 7:30am. Other patients will be scheduled to use the monitor.

To learn more about the kidneys, click here: http://www.kidney.org/