Hemodialysis access procedures

Definition

An access is needed for you to get hemodialysis. The access is where you receive hemodialysis. Using the access, blood is removed from your body, cleaned by the dialysis machine (called the dialyzer), and then returned to your body.

Usually the access is put in your arm but it can also go in your leg. It takes a few weeks to a few months to get an access ready for hemodialysis.

Description

A surgeon will put the access in. There are three types of accesses.

Fistula:

Graft:

Central venous catheter:

Why the Procedure Is Performed

Kidneys act like filters to clean out extra fluid and waste from your blood. When your kidneys stop working, dialysis can be used to clean your blood. Dialysis is usually done 3 times a week and takes about 3 to 4 hours.

Risks

With any type of access, you have a risk of developing an infection or a blood clot. If infection or blood clots develop, you will need treatment or more surgery to fix it.

Before the Procedure

The surgeon decides the best place to put your vascular access. A good access needs good blood flow. Doppler ultrasound or venography tests may be done to check blood flow at a possible access site.

Vascular access is often done as a day procedure. You can go home afterwards. Ask your doctor if you will need someone to drive you home.

Talk to your surgeon and anesthesiologist about anesthesia for the access procedure. There are two choices:

After the Procedure

Here is what to expect:

Call your doctor if you have any signs of infection:

Outlook (Prognosis)

Taking care of your access will help you keep it as long as possible.

A fistula:

Your artery and vein heal after each needle stick for hemodialysis.

A graft does not last as long as a fistula. It can last 1 to 3 years with proper care. Holes from the needle insertions develop in the graft. A graft has more risk of infection or clotting than a fistula.


Review Date: 8/1/2017
Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 03/05/18.

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