Hemodialysis Access

Arteriovenous Fistula

One of the important steps before starting hemodialysis treatments is preparing a vascular access, which is the site on your body where blood will be removed and returned during the dialysis procedure. To maximize the amount of blood cleansed during hemodialysis, the vascular access should provide high volumes of blood flow continuously during the treatment.

A vascular access should be prepared weeks or months before you start dialysis. It will allow easier and more efficient removal and replacement of your blood with fewer complications. There are three basic kinds of vascular accesses for hemodialysis:

• Atriovenous (AV) fistula
• Atriovenous (AV) graft
• Venous Catheter

The AV fistula is considered the best long-term access for hemodialysis because it provides adequate blood flow, lasts a long time, and has a complication rate lower than the other access types.

Possible complications

All three types of vascular accesses can have complications that require further treatment or surgery. The most common complications are access infection and low blood flow due to blood clotting in the access.

Taking care of your access

You can do several things to protect your access:

• Make sure your nurse or technician checks your access before each treatment.
• Keep your access clean at all times.
• Use your access site for dialysis only.
• Be careful not to bump or cut your access.
• Don't let anyone put a blood pressure cuff on your access arm.
• Don't wear jewelry or tight cloths over your access site.
• Don't sleep with your access arm under you head or body.
• Don't lift heavy objects or put pressure on your access arm.
• Check the pulse in your access every day.

You and your physician will determine the type of access best for your condition.

For more information contact your healthcare provider or email cardiology@highlinemedical.org.