Maintaining a functional access is critically important for your hemodialysis treatment. However, we recognize that all accesses require maintenance. Due to this eventuality, it is extremely important that you keep in close contact with your vascular physician who created the access.
We have many resources and capabilities to care for your access, so let’s discuss what is involved and how we can assist you.
How Does a Dialysis Access Work?
Dialysis access is a surgically created pathway for waste to travel out of the bloodstream and into a hemodialysis machine. Hemodialysis (hemo means blood) filters toxins from the blood using a dialyzer, also referred to as an artificial kidney. Without access, you would not be able to get dialysis.
Access allows blood to leave the body, travel through the tubing and enter a dialyzer where it is filtered and returned to the body through another tube called return blood tubing. They may remove blood from the body via needles inserted into one of several types of dialysis accesses.
Types of Dialysis Access
There are two primary types of dialysis access: arteriovenous (AV) fistulas and AV grafts. Both types of access last longer than catheters and are associated with less complications.
A fistula is made by connecting an artery directly to a vein under the skin in your arm. This is done through a small operation. A graft is made by connecting a synthetic tube between an artery and a vein.
Both allow blood to flow directly from an artery into a vein, which has more capacity for blood flow than capillaries (very tiny blood vessels). This higher capacity allows large volumes of blood to be removed, cleaned, and returned during dialysis.
Most people start with grafts, but most prefer fistulas because they can last longer and have fewer problems with infection. Fistulas also give better results on dialysis because they allow more efficient removal of waste from the body.
How Can You Make Your Dialysis Access Last Longer?
How long your access lasts depends on how you care for them. Your lifestyle choices also can help your dialysis access last longer. Here are some simple steps you can take to help make sure your dialysis access works well for as long as possible:
Keep the area around your access clean at all times. Wash your hands before touching your dialysis access and clean any access areas that are touched during treatment. Provide adequate amounts of skin moisturizer if you note that your skin is dry near the access.
Avoid using any product on or around the site that burns, stings, itches, or contains alcohol, iodine, or fragrance.
Avoid Wearing Constrictive Items
Wear loose-fitting clothing around the access site to avoid putting pressure on the site while moving around during the day.
Avoid activities that might hurt your access site, like sports, typing for long periods, housework that requires lifting heavy objects, and sleeping in an awkward position for long periods. Additionally, you should avoid hitting or damaging your access arm because this can weaken the vessel wall and lead to problems later.
What If My Access Fails?
Unfortunately, it is not a matter of “if”, but “when”. An important process of dialysis involves putting large needles into the access every dialysis session. It is natural that over time the access slowly gets broken down and requires inspection by a physician. It is, of course, best to repair an access before it fails or clots. Usually, there will be warning signs. When you are on certain dialysis machines there are measurements that can be made to calculate the flow rates and pressures. If these fall below normal capacities, this will be a sign of potential failure.
When an access does fail, it is important to restore functionality immediately. The longer an access remains closed, the harder it will be to get it started or open again.
Fortunately, The Cardiovascular Care Group is staffed with physicians and nurses who understand your anatomy and are uniquely qualified to “revive” your access. In most cases, functionality can be restored through minimally-invasive techniques. However, should you need a more involved approach we are ready to provide any therapy necessary to get your dialysis access working again.
We’re Here to Help!
It's crucial to take good care of your access because problems with the access are among the most common reasons people miss dialysis treatments. If you notice issues, contact your dialysis team immediately. We are committed to simplifying your dialysis experience.