Abstract
Hemodialysis has been provided free of charge by Nepal’s Ministry of Health and Population since 2016, providing services to a growing population of dialysis-dependent patients nationwide. Despite expanded access to free hemodialysis, geographic and socioeconomic barriers delay the timely management of dialysis access problems in Nepal. This leads to frequent presentation with advanced complications, including infection. We present the case of a 33-year-old male patient with an infected AV fistula, whose presentation for definitive evaluation and treatment was delayed by the remote location of his dialysis clinic and the paucity of Vascular Surgeons in Nepal. Findings may have applicability for other geographies and resource-constrained contexts facing similar barriers to maintaining hemodialysis access.
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