For end-stage renal disease patients on hemodialysis, proper vascular access is vital. As nephrologists' workloads increased, vascular access management shifted to interventional radiologists or vascular surgeons. This specialization created communication barriers between disciplines, potentially compromising patient care. Consequently, interest in interventional nephrology grew, enabling nephrologists to take more direct roles in vascular access management. In response to this situation, dedicated vascular access nephrology fellowships were established in South Korea. However, in 2024, residents and fellows resigned en masse protesting government healthcare policies—an unresolved situation representing a significant loss for medicine and ESRD patients. In this context, a resigned thoracic surgery resident began practicing at "Lifeline Clinic" under an interventional nephrologist's supervision. We retrospectively analyzed cases performed under interventional nephrology supervision from August 2024 to March 2025. The resigned resident served as primary operator while the supervisor observed the entire procedure. In cases of complications or high procedural difficulty, the supervisor took over to complete the intervention. During this period, 406 endovascular percutaneous transluminal angioplasties were performed with a 100% success rate. Additionally, 16 endovascular thrombectomies were conducted: 4 on native AVFs and 12 on AVGs, achieving a 100% success rate. No complications requiring hospitalization occurred during these procedures. Cases where the primary operator was changed due to procedural difficulty were not separately analyzed in this study. The fellowship program developing new interventional nephrologists has been severely damaged by the government's unilateral policy implementation under the guise of healthcare reform. However, it is encouraging that a resident who discontinued training was able to achieve good outcomes in vascular access care under appropriate supervision. While the future remains uncertain, we believe "this too shall pass," and interventional nephrologists' efforts for CKD patients will continue into the next generation.