How is Blood Removed and Replaced?
Due to the high flow of blood that is needed for hemodialysis, patients and their doctor will discuss creation of an “access.” There are three primary types of access:
- Fistula “” A fistula is the preferred option for an access due to fewer complications and better patient outcomes. This involves directly linking an artery to a vein. It is an outpatient surgical procedure, typically performed by a vascular surgeon, and is usually placed on a patient’s non-dominant arm. The fistula takes up to six weeks to mature before it can be used for dialysis.
The advantages of using a fistula are:
- Higher blood flow, which means more efficient and effective dialysis
- Lower infection rates because there are no manmade, foreign body materials involved
- Lower risk of blood clot formation
2. Graft “”Also created in an outpatient surgical procedure, a graft uses a special tubing or donated vein to connect the artery to a vein.
The advantages of a graft include:
- Grafts may be placed in the lower or upper arm or the thigh.
- Typically matures faster than a fistula, so patients can undergo dialysis sooner.
3. Venous Catheter “” When you need a more immediate, temporary access for dialysis, doctors will consider placing a catheter in your chest. This type of access is considered for short-term or emergency use.
The advantages of a venous catheter:
- It’s a viable option for those whose kidney disease has progressed so rapidly that the time delay of healing from a fistula or graft is not an option.
- It can be used in patients who have problems with fistula or graft surgery.