Dialysis Access Management

What is Dialysis?

Dialysis is a treatment that performs the work of the kidneys when they are no longer able to function properly. Healthy kidneys remove waste products, extra fluid, and toxins from the blood. When kidney function drops to a critical level, dialysis helps filter the blood to keep the body in balance.

There are two main types of dialysis:

• Hemodialysis: Blood is filtered through a machine outside the body and returned clean.
• Peritoneal dialysis: The lining of your abdomen acts as a filter using a special dialysis solution.

For patients starting hemodialysis, creating and maintaining reliable vascular access, such as a fistula, graft, or catheter, is a critical first step to ensure effective treatment.

HOW HEMODIALYSIS IS DONE

Two needles are inserted into a blood vessel (called an arteriovenous fistula or AV fistula) or an arteriovenous graft (or AV graft), usually in your arm. Each needle is attached to a tube. One tube carries your blood into the dialyzer, where it’s cleaned. Clean blood returns to your body through a second tube and needle. If this treatment has to be done in an emergency, a plastic tube (catheter) is inserted into a large vein, typically in the neck or groin. This catheter helps carry blood to and from the dialysis machine.

YOUR EXPERIENCE: PROBLEMS TO WATCH FOR

• Hemodialysis usually takes about 3 to 5 hours. It’s usually done 3 times a week.
• You’ll have a regular schedule for your hemodialysis. Many centers have evening and weekend hours as well as weekday hours to help you continue working. Some centers also offer overnight treatments.
• A trained nurse or technician connects you to the dialysis machine. He or she watches for problems and makes sure you are comfortable.
• During treatment, only a small amount of blood (about 1 cup) is out of your body at any one time.

During your treatments, you may have a headache, muscle cramps, nausea and vomiting, chest and back pain, itching, and fever and chills. Make sure you tell your nurse or technician if you have any of these symptoms.

Some people are able to learn to use dialysis at home. Home dialysis lets you schedule treatments when it’s most convenient. You may have more frequent treatments, but for shorter periods of time. You may also do overnight treatments.

What to Expect from Dialysis Access Care

At The Surgical Clinic, we guide you through every stage of your dialysis access journey:

1. Initial Consultation: You’ll meet with one of our vascular surgeons to discuss your health history, dialysis needs, and the best type of access for you.
2. Access Creation: We perform your procedure, whether it’s an AV fistula, graft, or catheter placement, using advanced techniques to ensure safety and long-term function.
3. Recovery & Maturation: After surgery, your access needs time to heal and, in the case of fistulas, to mature before use. Our team will provide instructions for recovery and follow-up visits.
4. Ongoing Management: We monitor your access for complications such as clotting, narrowing, or infection, and provide treatments when needed to keep it working properly.
5. Long-Term Support: Our team partners with you and your dialysis center to make sure your access continues to function effectively for years to come.

With expert care and regular monitoring, you can count on reliable access to support your dialysis treatments.

MANAGING AND LOWERING YOUR RISK OF DIALYSIS SIDE EFFECTS

Everyone’s experience with dialysis is unique, and while side effects can sound daunting, there are practical steps you can take to lower your risk:

• Communicate openly with your care team: Let your doctor, nurse, or dialysis technician know right away if you notice any changes or feel unwell during or after treatment. The earlier you share your concerns, the easier it is to adjust your care.
• Follow your treatment plan: Stick to your recommended dialysis schedule, take medications as prescribed, and arrive at your sessions on time. Consistency helps your body adjust and reduces complications.
• Watch your diet and fluids: Work with a dietitian who specializes in kidney care (often called a renal dietitian) to maintain a diet tailored to your needs. Controlling sodium, potassium, and fluids can make a big difference in your comfort and long-term health.
• Take care of your access site: Check your fistula or graft daily for redness, swelling, or pain and keep the site clean. If you notice changes, notify your care team as soon as possible.
• Stay active: Gentle physical activity, cleared by your doctor, can help reduce fatigue and muscle cramps. Even walking or stretching can make treatments easier to tolerate.
• Educate yourself: The more you know about dialysis and your own health, the more confident you’ll feel about handling side effects and making informed choices.

Remember, while side effects are possible, untreated kidney failure comes with much greater risks. By staying informed and engaged in your own care, you can make your dialysis journey safer and smoother.

When to Talk to Your Doctor

Get immediate medical help or call your doctor, nurse or dialysis technician if you have any of these symptoms after treatment:

• Chest or back pain
• Tiredness (fatigue)
• Bleeding from the needle site
• Shortness of breath
• Fever or chills
• Headache or lightheadedness
• Nausea or vomiting
• Itching
• Muscle cramps
• Pain, warmth, or redness at your access site
• Inability to feel your blood flow (called a thrill) in your AV fistula or graft

Take the Next Step Toward Reliable Dialysis Access

Your dialysis access is your lifeline, and it deserves expert care. At The Surgical Clinic, our board-certified vascular surgeons specialize in creating and maintaining fistulas, grafts, and catheters to keep your treatments safe and effective.

Frequently Asked Questions

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