Dialysis Access

About Dialysis Access

The kidneys, located in the posterior abdominal cavity, purify and filter wastes from the blood, secreting them in urine. When the kidneys fail (and before/until a kidney transplant is available), hemodialysis is a way of artificially filtering the blood outside the body. A special site, called an access, is required to facilitate dialysis.

What is hemodialysis?

Hemodialysis is a treatment for individuals with failing kidneys wherein a machine filters wastes, salts, and fluid from the blood when the kidneys can no longer do this filtering on their own. Dialysis can help prolong life and improve quality of life, but there can also be complications and it's important to understand how dialysis works to best care for your access site.

What is a dialysis access?

A dialysis access, also called a vascular access, is a port or passage that allows for easy access to your bloodstream. It allows for a small amount of blood to be removed from and then returned to your circulation safely.

Dialysis access procedures

At Vascular & Interventional Specialists, we offer the full spectrum of access care for dialysis patients, including fistula creation, fistulogram, and catheter placement or replacement. Each option for dialysis access has pros and cons, so you should discuss your options with your doctor.

Fistula

A fistula, also called an arteriovenous or AV fistula, is a surgical graft between an artery and a vein, usually in the non-dominant arm, that allows for dialysis access. The procedure is typically done four to six months before your first dialysis treatment to allow the fistula to heal and strengthen so it can withstand the rigor of several hours-long dialysis treatments a week.

Fistulogram

A fistulogram is an X-ray used to look for abnormal areas, narrowing, or blockages in the fistula that may be causing problems with dialysis. The procedure is safe and minimally invasive. During a fistulogram, a catheter is inserted into the fistula and a dye is injected and visualized with the X-ray machine.

Catheter placement/replacement

A catheter for dialysis access is a tube connected to a large vein in the neck or upper chest. Catheters are common for temporary or emergency dialysis. The chance for infection is higher with a catheter than with other types of accesses.

Peritoneal dialysis catheter placement

In some cases, peritoneal dialysis can be an alternative to hemodialysis. In peritoneal dialysis, the lining of the abdomen (called the peritoneum) is used to filter wastes from the blood. To facilitate peritoneal dialysis, your surgeon will place a catheter near your navel.

Caring for your access site

  • Wash with soap daily and always before dialysis.

  • Avoid scratching your access.

  • Check for redness, soreness, swelling, excess warmth, or the start of a pimple on any area of your access.

  • Ask your care team to rotate needles when you have your dialysis treatment.

  • Follow any other instructions from your care team.

Get expert care close to home

Our friendly physicians at Vascular & Interventional Specialists are board-certified and fellowship-trained in care and treatment for a variety of vascular conditions, including dialysis access.

Contact us or call our clinic at 605-217-5617 to schedule an appointment.

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