Vascular Access Services
Before hemodialysis can be done, caregivers must have access to a patient’s bloodstream. This is called vascular access.
Good vascular access is hard to underestimate. It allows the patient’s blood to travel to and from the dialysis machine at large volume and high speed, so toxins, waste and extra fluid can be removed from the body more efficiently.
Types of Dialysis Access
Arteriovenous (AV) fistula
- A connection between an artery and a vein, often in your arm
- Usually considered the best option for dialysis access
- Tends to provide reliable dialysis access with a low risk of infection
- Can take months to mature and be ready for use after access surgery
- Many people have an anatomy which makes an AV fistula hard to create
Arteriovenous (AV) graft
- A connection between an artery and a vein using a tube created from man-made material
- A good option for people with small veins or other anatomic features which make an AV fistula hard to create
- Can be ready for use in as little as two weeks, or even sooner in some cases
- May close more quickly and can have a higher infection risk
Tunneled dialysis catheter (or venous catheter)
- A soft tube placed in a large vein in your neck, chest, or leg
- Allows blood to flow in and out of the dialysis machine
- Can be ready for use right away
- Poses a higher risk of blood clots and infection compared to a fistula or graft
Caring for a fistula or graft
How to take care of your access:
- Keep your vascular access area clean. Your dialysis care team will teach you how to carefully wash it before each treatment.
- Look for signs of infection including pain, tenderness, swelling or redness around your access area.
- If an infection is detected early, it can be treated with antibiotics.
How to protect your access from trauma:
- Avoid tight clothes, jewelry or anything else that puts pressure on your access
- Do not sleep on top of, or rest on, your access area
- Always carry bags or heavy items with your non-access arm
- Request that blood be drawn from your non-access arm
- Request that blood pressure be taken on your non-access arm
- Learn to feel the vibration of blood going through your access and check it several times a day. Call your dialysis care team immediately if the flow stops or changes, as this could indicate that a blood clot has formed and needs to be treated.
- Learn how to listen with a stethoscope to the sound of blood flowing through your access. If the sound changes to a higher pitch, like a whistle, it could be an indication that blood vessels are narrowing. Call your dialysis care team if you notice any change in your access.