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How you prepare

By Mayo Clinic staff

Preparation for hemodialysis starts several weeks to months before your first procedure. To allow for easy access to your bloodstream, a surgeon will create a vascular access, usually referred to as an access. It is the place on the outside of your body where blood is removed for hemodialysis and then returned. The surgical access needs time to heal before you begin hemodialysis treatments.

Three types of accesses are used:

  • Arteriovenous (AV) fistula. A surgically created AV fistula is a connection between an artery and a vein, usually in the forearm of your nondominant arm. This is the preferred type of access.
  • AV graft. If your blood vessels are too small to form an AV fistula, the surgeon may instead create a path between an artery and a vein using a flexible, synthetic tube called a graft, sometimes called a synthetic bridge graft.
  • Central venous catheter. If you need emergency hemodialysis, the surgeon may insert a plastic tube (catheter) into a large vein in your neck or near your groin. The catheter is temporary.
References
  1. Hemodialysis. National Kidney Foundation. http://www.kidney.org/atoz/content/hemodialysis.cfm. Accessed Oct. 19, 2010.
  2. Treatment methods for kidney failure: Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/Kudiseases/pubs/hemodialysis. Accessed Oct. 19, 2010.
  3. Himmelfarb J, et al. Hemodialysis. In: Brenner BM, et al. Brenner and Rector's the Kidney. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-3105-5..50060-8&isbn=978-1-4160-3105-5&type=bookPage&sectionEid=4-u1.0-B978-1-4160-3105-5..50060-8--cesec2&uniqId=223035191-9. Accessed Oct. 19, 2010.
  4. Hemodialysis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec17/ch234/ch234b.html. Accessed Oct. 19, 2010.
  5. Crawford PW, et al. Treatment Options for End Stage Renal Disease. Primary Care: Clinics in Office Practice. 2008;35:407.
  6. Schmidt RJ, et al. Psychiatric illness in dialysis patients. http://www.uptodate.com/home/index.html. Accessed Oct. 19, 2010.
  7. Perl J, et al. Home hemodialysis, daily hemodialysis, and nocturnal hemodialysis: Core curriculum 2009. American Journal of Kidney Diseases. 2009;54:1171.
  8. Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 23, 2010.
MY00281 Dec. 11, 2010

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