Dialysis Access

What is Dialysis?

If your kidneys fail, your body is unable to clean and filter your blood and get rid of extra water and waste products. Your body will need extra help removing the water and waste products with dialysis therapy – either for the rest of your life or until you have a successful kidney transplant.

A dialysis machine pumps blood through the filter and returns the blood to your body. Your kidney specialist will discuss all the options with you around how and where your dialysis will take place.

Why do I need Dialysis Access?

Getting started on dialysis requires you to establish Dialysis Access. This is the method used to access blood from your body and filter it through the dialysis machine before it goes back into your body again.

What is involved in Dialysis Access?

There are three main types of dialysis access. Your vascular surgeon has specialist knowledge of these procedures and your medical team will discuss all the options with you to work out what’s best for you.  

The most common way to create dialysis access is through an AV fistula or AV graft. These create a more permanent solution and are less prone to infection. Your surgeon will use an ultrasound to map your veins on the arm or leg selected to see if they are large enough for an AV fistula. If not, an AV graft will be needed. 

If you are using Peritoneal Dialysis, your vascular surgeon will establish Dialysis Access through a cannula in your abdomen.

AV fistula

  • Your Vascular Surgeon will take a piece of a vein (usually from your arm or leg) and sew it into a nearby artery.

  • The sewn-in vein gets bigger and thicker (like an artery) and we can access the blood.

AV graft

  • Your Vascular Surgeon will sew a prosthetic graft between an artery and vein in your arm or leg.

  • A good option if your veins are too small for an AV fistula.

Peritoneal dialysis

  • Your Vascular Surgeon will place a small tube, called a cannula, in your abdomen.

  • This allows the use of the lining of the abdomen (peritoneum) to filter your blood through the tube.


Where will my Dialysis Access procedure be performed?

Your procedure to establish Dialysis Access will be performed at the hospital agreed on with your doctor. If there are any special requirements, your medical team will let you know beforehand.

What are the risks of Dialysis Access?

Bleeding is the most common complication of Dialysis Access. The medical team in hospital will monitor you carefully following your surgery to check that everything is progressing as it should.

The following symptoms are common:

  • A slight coolness in the affected hand or leg – this happens because some of the blood supply has been redirected.

  • A slight buzzing feeling near the fistula or graft – this means that it’s working correctly.

You should contact your vascular surgeon immediately if:

  • You notice swelling or any dressings become saturated with blood.

  • Your hand or leg becomes very cold or numb.

  • The buzzing feeling near the fistula becomes a pulse – this may indicate that the access has narrowed.

What will my recovery be like after surgery for Dialysis Access?

The first six weeks are critical to developing strong Dialysis Access.

As with any surgery, you’ll probably feel pain at the site of the incision for some time after the operation. This may be several days to a few weeks. You will be given pain medication to be more comfortable.

You’ll also be shown how to monitor and care for your fistula or graft. This may include some simple exercises to help strengthen the blood vessels.

If you have any questions, please don’t hesitate to ask the team at Vascular Associates.