History of Present Illness (HPI)
A 50 year-old man on outpatient hemodialysis 3 times a week is admitted to your hospital with a lower extremity foot infection. He is on intravenous antibiotics and is scheduled to go to the operating room in a few days with your vascular surgery colleagues for further management of the infections.
He receives hemodialysis through a right upper extremity arteriovenous fistula (AVF) that he says was placed a few years ago. Of note, he tells you that recently there has been difficulty with cannulation and he has been skipping some of his dialysis treatments because of this. He also notes that recently, clots have been pulled from the fistula after cannulation.
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