If you have kidney disease, you may need dialysis therapy to clean and filter your blood. The first step is to establish dialysis access.
For hemodialysis patients, we commonly use the wrist or forearm for dialysis access. We offer fistula, graft and catheter-based techniques. Whenever possible, we try to use an AV fistula, considered the "gold standard" for dialysis access. For patients who are not fistula candidates, we also use grafts and catheters.
- Arteriovenous (AV) fistula: Your doctor connects a vein to an artery to create an AV fistula. The fistula takes a few months to develop after surgery. Once formed, it can last for years, providing access with good blood flow.
- Graft: Your doctor connects an artery to a vein by inserting a graft, or plastic tube, under your skin. A graft can be used for dialysis within a few weeks of placement.
- HeRO Graft: The HeRO graft is an option for patients with limited dialysis access who have previously undergone dialysis treatment often. It provides an alternative to tunneled dialysis catheters. With the help of X-ray imaging, your doctor inserts a tube (called the outflow component) into a large vein in your neck. This tube connects to a regular dialysis graft placed in an artery.
You and your doctor will decide which type of dialysis access is right for you. Your doctor will consider many factors, such as whether veins are blocked or too small to use, and how quickly you need to start dialysis treatment.