Hemodialysis is a way to help people with kidney problems. When your kidneys aren't working right, hemodialysis uses a special filter to clean your blood and get rid of extra things your body doesn't need. Your doctor may suggest hemodialysis if your kidneys aren't doing their job.
To make hemodialysis work, doctors need a spot on your body where they can easily reach a vein and an artery. This spot lets them take some blood out of your body, clean it with a machine, and then put the clean blood back in. These are
Vascular Access Options
A vascular access is a place on your body close to a vein and artery. This place allows access to your blood stream for removal of blood from your body. There are three major types of vascular access used for hemodialysis:
- Arteriovenous Fistula (AVF): An AVF is created by connecting one of your arteries to a vein under your skin. It uses your body's own blood vessels and is the best and safest long-term option. It has the lowest risk of infection and can last for many years. However, it takes time—weeks or months—to heal and be ready for use.
- Arteriovenous Graft (AVG): If your veins aren't suitable for an AVF, your doctor may use a soft plastic tube called a graft to connect an artery and vein. Grafts can be used sooner after surgery but don't last as long. They are at higher risk of infection or clotting.
- Catheter: A catheter is a soft plastic tube inserted into a big vein. The site for catheter insertion is usually in your neck or chest. The ends remain outside the skin for easy access of the dialysis machine. Catheters allow immediate dialysis but have a higher risk of infection and are not ideal for long-term use. They are often used while waiting for an AVF or graft to heal.
Caring for Your Access
Caring for your access site makes it last longer and will help keep you healthy.
Keep it clean: Wash the area with soap and water daily and before each treatment.
- Protect your arm: Do not let anyone take blood pressure or draw blood from your access arm. Avoid tight clothing or sleeping on that arm.
- Check it daily: feel for a “thrill” (a gentle vibration) and listen for a “whooshing” sound. If neither of these is present, you should call your dialysis team immediately. Watch for infection-infection can be indicated by redness, swelling, pus, or fever; report these to your care team immediately.
- Exercise your arm: Squeezing a stress ball can help strengthen your access site.
Choosing the Right Option
Your doctor will help determine the most appropriate type of access for you, taking your health, veins, and the urgency for dialysis treatment into consideration. Fistulas are preferred for long-term dialysis because they're safest and last longest. Grafts are good if the veins aren't strong enough for a fistula. Catheters are for short-term or emergency use. Caring for your access site and working closely with your dialysis team will help you stay healthy and make each treatment as effective as possible.
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