Dialysis Access Options

Things you should know if you have known kidney failure and require hemodialysis.

All who face chronic kidney failure and are managed on Dialysis in turn also face Peripheral Vascular Disease. For this reason, we wanted to provide relevant education.

Hemodialysis is a process used to clean the blood when the kidneys fail to work properly. Learn more about Kidney Failure

It is a safe way to artificially remove toxic products that can build up in the bloodstream and re-establishes normal fluid balances.

In order to start this blood-cleaning process known as “Hemodialysis”, access to the blood must first be gained through a large sturdy blood vessel.

For this, there are 3 options:

The 3 Main Dialysis Access Options

Best long-term Dialysis access option. Also known as an Arteriovenous Fistula or AV Fistula (AVF). This access option is created surgically by connecting a vein to an artery. Once created, approximately two to three months are given for the fistula to mature before dialysis use.

When an AV Fistula cannot be made for various reasons, an arteriovenous Graft (AVG) can be created as an excellent alternative & long-term option. A Graft is created surgically. However, instead of connecting an artery and vein directly together, a sturdy tubing is placed in between the artery and vein. This tubing becomes the Dialysis access site.

For short-term dialysis access a CVC will likely be used. This option is best for temporary dialysis needs for hospitalized patients or those waiting for maturation of the Graft or AV Fistula. CVC’s are typically placed into a large vein in the neck or your groin and the line is inserted into your heart’s right atrium. There is no wait time for its use, making it the best choice for immediately dialysis needs.

Having Issues with your Dialysis Fistula, Dialysis Graft or Central Venous Catheter?
Should any of these access options partially or completely stop working, talk to your doctor right away.
(The most common cause is most often due to clotting.)

Help Kern residents prevent PVD

Whether Slow Flow, No Flow, Pain or Redness around the access site or any of the above issues, be sure to tell your doctor about any noticeable problems with your dialysis access site.

Common Complications of Hemodialysis Access sites:

  • Hyper-pulsatile or slow flowing blood in access area
  • Swelling or “pins and needles” in the access area
  • Pressures in the site can change and might set off alarms in Dialysis machines
  • Difficulty stopping the bleeding after dialysis treatment
  • Inefficient treatments known as “recirculation”. Treated blood from the dialysis machine mixes with the untreated blood to the patient, recycling inadequately treated blood to the patient. This often leads to inadequate measures of dialysis dose.
  • If a blockage occurs and persists for too long, a clot can form locally or above the access site. This is known as a “thrombus”.

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