What is hemodialysis and how can it be performed?

Dialysis, also called hemodialysis, is the most common treatment for kidney failure.  A dialysis machine removes impurities from your blood, taking the place of non-functioning kidneys.  In order to remove and replace your blood, a large access to your blood stream is required.  The access can be through a large IV placed near your collar bone or groin (called a vascular access catheter), or can be actually created under your skin in your arms or legs (called a fistula or graft).  Creating this access portal, or "fistula", under your skin is a minor surgical procedure which involves connecting an artery directly to a vein ("AV fistula").

  • Native Fistula- A simple connection between the artery and vein.
  • Graft Fistula- A plastic tube is connected between the artery and vein.

What types of vascular access catheters can be placed?

Through a procedure that takes less than 30 minutes, a vascular access catheter (or venous catheter) can be placed into your vein.  At the Interventional & Vascular Center, we are proud to not only precisely placed these catheters, but we also will ensure proper function of them.

Temporary catheters can be placed if hemodialysis is only required for a few weeks.  

Tunneled catheters are inserted under the skin for a few inches prior to entering your vein.  By tunneling the catheter, there is less risk for skin bacteria from infecting the catheter itself or getting into your bloodstream.

What problems can develop with my vascular access?

All three types of vascular access for dialysis (AV fistula, AV graft, and a venous catheter) can develop problems which typically can be quickly repair by our interventional radiologists.  The most common problems include low blood flow due to clotting or narrowing of the vein.  Through a simple procedure called a fistulogram, contrast is injected into the fistula under fluoroscopy (or live x-ray).  Once a narrowing or blockage is discovered, the vein can be fix through a procedure called venoplasty.  This will stretch the vein back to it's normal size, keeping flow through the fistula at the best possible.  

Other problems that can develop are catheter-related infections.  Typically, we simply replace the catheter (through the same access site), and the infection will resolve with oral antibiotic therapy.

What is recommended to keep my dialysis access in good shape?

  • Keep the access site clean at all times
  • ​Use the access site only for dialysis
  • Do not wear tight clothing or jewelry over the access site
  • Do not ever place a blood pressure cuff on the same arm or leg as the access site
  • Minimize heavy lifting with the access site arm
  • Alert your physician if there's any sign of infection such as redness, tenderness, or pus​

Dialysis Access