06/11/2016
3 types of dialysis access sites
Fistula
A fistula is considered the best choice for hemodialysis. It is made with your own blood vessels, provides optimal blood flow and has the lowest chance of infection.
To create a fistula, a surgeon connects one of your arteries to a vein under the skin of your upper or lower arm.
If possible, the fistula access should be placed at least 2 to 3 months before you begin dialysis to allow time for it to develop and mature. However, your doctor will recommend appropriate timing.
If you are unable to have surgery for a fistula before you begin treatment, it is still possible to do so after your treatment has begun. It is especially recommended if you have had to opt for a temporary catheter.
During treatment, a nurse places 2 needles into the fistula. These needles are connected to tubing that lead to and from the dialysis machine. During dialysis, your blood flows out of your body through one needle that is connected to your artery and into the dialysis machine. After your blood is filtered, it returns to your body through the other needle, which is connected to your vein.
Graft
A surgeon connects your artery to a piece of soft tubing that acts like a vein. It’s placed under the skin of your upper or lower arm.
During treatment, a nurse places 2 needles into the graft. These needles are connected to the tubing that lead to and from the dialysis machine. During dialysis, your blood flows out of your body through one needle connected to your artery and into the dialysis machine. After your blood is filtered, it returns to your body through the other needle, which is connected to your vein.
Catheter
Most catheters are temporary and used only until a fistula or graft is ready.
If your blood vessels are not strong enough for a fistula or graft, you may be a candidate for a catheter.
Catheter access is inserted by a kidney doctor (nephrologist) or surgeon.
A long Y-shaped tube (catheter) is placed in your neck, chest or groin and is connected to a central vein. The other end of the tubing exits your skin and attaches to the tubing on the dialysis machine.
A catheter can be used immediately after placement.
Since catheters have a higher risk of clotting and infection and provide a slower blood-flow rate, they are not recommended for the long-term. If you have a catheter, talk to your doctor to see if you are a candidate for a fistula or graft.