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Dialysis Access


We have two kidneys in our bodies. We only need one half of kidney to function properly to survive. If both kidneys fail to work it will result in kidney failure (Renal Failure). Hemodialysis is one of the most common methods that replaces our kidneys. Dialysis access is the general term applied to all access techniques used for hemodialysis.
Timing is very important in planning a dialysis access. Directed communication between the Nephrologist and Vascular Surgeon is very crucial. Usually GFR which is a calculation of the renal function is the indication for dialysis.

Dialysis Access types:

Catheters; are either short term or long term. They have high risk of complications. for instance infection occurs in about 20-30% of all catheters. Central venous stenosis is another direct complication of dialysis catheters.
Arterio-Venous Access; is a communication between an artery and a vein. As a result a conduit will be created to be accessed by the dialysis needles.
    • Arteriovenous Fistula: is a direct anastomosis between an artery and a vein. This will result in the vein to enlarge and be thicker. It is the best option. It has the lowest complications rate between all types of access. It is a created via a minor surgery; which could be done under local anesthesia. It requires between 2-3 months to be ready to be used.
    • Arteriovenous Graft: is using a prosthetic graft conduit to make a communication between an artery and a vein. It take 2-3 weeks to be ready to be used. it has a higher rate of infection.
Peritoneal dialysis: placement of a small tube, called a cannula, in your abdomen to allow the use of the lining of the abdomen (peritoneum) to filter your blood. It requires several “exchanges” every day: you introduce and remove fluid through the tube.