12/13/2007Dialysis Access 101

Hemodialysis is a treatment used when your kidneys fail and can no longer clean your blood and remove extra fluid from your body.  A hemodialysis access or vascular access is a way to reach your blood for hemodialysis.

You have two kinds of blood vessels in your body:  arteries and veins.  Arteries are large, strong blood vessels that carry oxygen-rich blood from your heart and lungs to the rest of your body.  Veins carry blood back to your heart and lungs to pick up more oxygen. 

If you receive hemodialysis, your access is one of the following:

• AV Fistula
• AV Graft
• Catheter

AV fistulas are a direct connection between an existing artery and vein.  The fistula is usually placed in the forearm.  It is preferred that the fistula be placed on the “non-dominant” arm or the arm that you do not use as frequently.  A few months are usually needed to allow the fistula to properly develop, although it may take longer in some cases.

AV grafts are similar to AV fistulas.  Unlike the fistula which directly connects an artery to a vein, an AV graft uses a synthetic tube to create an indirect connection.  The tube acts like a natural vein allowing blood to flow through.  Grafts are more prone to clotting and infection compared to fistulas.

A catheter (also called a permacath) is place into a large vein to allow dialysis.  Catheters are flexible, hollow tube which allows blood to flow in and out of your body.  They are most commonly used as a temporary access for up to three weeks.  It is generally placed when there is not enough time to allow a fistula to mature.

Here is a great link for more information:

Vascular Access for Hemodialysis
Illustrated Guide from NKUDIC Website

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