Dialysis is a life-saving treatment for patients with kidney failure, removing waste and excess fluid from the blood when the kidneys can’t. Effective dialysis access is crucial for connecting patients to dialysis machines in order to cleanse the blood. There are multiple different types of dialysis access options, your surgeon will help in determining the best option for you.
If your doctor is recommending dialysis, here are some terms you may need to know:
- Arteriovenous fistula
- Arteriovenous graft
- Central venous catheter
- Peritoneal dialysis
Types of Dialysis Access
Dialysis access is essential for kidney treatment, with four main types.
1. Arteriovenous fistula
An arteriovenous (AV) fistula is a special connection made by doctors between an artery and a vein in your arm or leg. It’s created to help with kidney dialysis, a treatment that cleans your blood when your kidneys can’t. Your doctor makes a small cut and joins the artery to the vein which causes more blood to flow through the vein, making it bigger and stronger.
AV fistulas are the best choice for long-term dialysis because they last longer and are less likely to get infected compared to other options. They also present a lower risk of clotting off compared to other methods.
It takes about 6 to 9 months for an AV fistula to be ready for use. During this time, the connection grows and becomes strong enough for dialysis needles. Approximately 20-50% of AV fistulas may require reintervention because they may not grow large enough or have enough flow to successfully be used for dialysis.
While AV fistulas are generally safe, there can be some side effects. These might include:
- Infections
- Swelling of the vein
- Narrowing of the blood vessels
- Blood clots
Even with these risks, AV fistulas are still considered the safest and most reliable option for long-term types of dialysis access.
2. Arteriovenous graft
An AV graft is a tube-like structure made of a synthetic material. The graft is surgically placed under the skin to connect an artery to a vein, usually in the arm or sometimes in the leg.
Compared to AV fistulas, grafts can be used sooner, typically within 2-8 weeks after placement depending upon the material used. They’re also suitable for patients with inadequate veins for fistula creation. However, grafts have a shorter lifespan (about 2-3 years) and are more prone to complications like clotting and infections.
AV grafts are typically used when a patient is unsuitable for an AV fistula or needs dialysis access more quickly. They’re also an option when previous fistula attempts have failed.
Maintenance of AV grafts requires vigilant care. Patients must keep the area clean and avoid tight-fitting clothing or jewelry.
Minimally invasive interventions, called fistulograms, may be necessary to maintain graft or fistula patency and function. Thrombectomy removes blood clots using mechanical devices or medicine. Angioplasty uses a balloon catheter to widen narrowed blood vessels.
Both procedures aim to restore blood flow in grafts as well as fistulas, ensuring continued effective treatment for both types of dialysis access. Your vascular surgeon will perform these procedures when necessary.
3. Tunneled Central venous catheter
A tunneled central venous catheter (CVC) is a type of dialysis access placed under the skin and into a large central vein, typically the internal jugular vein.
CVCs can be used for both temporary (less than 21 days) and long-term access. They are ideal for immediate use, allowing dialysis to begin right after placement. This makes them suitable for patients needing urgent dialysis or as a bridge to more permanent types of dialysis access such as AV fistulas and AV grafts.
However, CVCs have significant drawbacks. They have the highest risk of infection among dialysis access types and can lead to complications like thrombosis and central vein stenosis. They also require longer dialysis times due to lower blood flow rates.
Proper care and maintenance are crucial for CVCs. This includes:
- Keeping the dressing clean and dry
- Avoiding sharp objects near the line
- Regular dressing changes by healthcare professionals
You should also avoid activities that might wet the dressing, such as swimming, baths, or showers.
4. Peritoneal dialysis
Peritoneal dialysis (PD) is a different method of removing waste from the blood. Rather than using a machine, it uses the lining of the abdomen (peritoneum) as a natural filter to remove waste and excess fluid from the blood.
It works by surgically placing a catheter in the abdomen. Through this catheter, a sterile cleansing fluid is introduced into the abdominal cavity. The solution remains in the abdomen for a set time, during which it absorbs waste products and extra fluid from the blood vessels in the peritoneum.
The used solution is then drained out and replaced with fresh solution, completing one cycle of the treatment. PD can be performed at home, offering patients more flexibility compared to other dialysis methods.
Dialysis Access in Evansville, IN
Vascular Surgical Associates in Evansville, IN, offers specialized care for various types of dialysis access. As a subsidiary of Evansville Surgical Associates, we provide state-of-the-art vascular care using advanced imaging technology.
Our experienced team of vascular surgeons can create and maintain different types of dialysis access, including fistulas and grafts. We emphasize minimally invasive procedures when possible, potentially leading to faster recovery times. We also collaborate closely with other healthcare providers to ensure comprehensive care for dialysis patients.
With multiple locations and a patient-first approach, Vascular Surgical Associates is well-equipped to handle your dialysis access needs in the Tri-State region.
Do you need to know about your options for dialysis access? Contact us today!
Dialysis access is crucial for kidney treatment, featuring three main types: AV Fistula, AV Graft, and Central Venous Catheter. Each has unique characteristics with Fistulas preferred long-term but need time to develop. Grafts offer quicker use while catheters provide immediate access but with higher infection risks. All types require proper maintenance for effective treatment. Peritoneal dialysis uses the lining of the abdomen as a natural filter to remove waste and excess fluid from the blood.
Vascular Surgical Associates provides comprehensive and compassionate surgical care to the tri-state area. Call us at (812) 424-8231 or (800) 264-8231 to contact us or schedule an appointment. We are available from 8:00 a.m. to 4:30 p.m. Central Time.
