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By Mayo Clinic staffPreparation 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. The access provides a mechanism for a small amount of blood to be safely removed from your circulation and then returned to you in order for the hemodialysis process to work. The surgical access needs time to heal before you begin hemodialysis treatments.
There are three types of accesses:
- Arteriovenous (AV) fistula. A surgically created AV fistula is a connection between an artery and a vein, usually in the arm you use less often. This is the preferred type of access because of effectiveness and safety.
- 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.
- Central venous catheter. If you need emergency hemodialysis, a plastic tube (catheter) may be inserted into a large vein in your neck or near your groin. The catheter is temporary.
It's extremely important to take care of your access to reduce the possibility of infection and other complications. Follow your health care team's instructions about caring for your access.
- Hemodialysis. National Kidney Foundation. http://www.kidney.org/atoz/content/hemodialysis.cfm. Accessed April 7, 2013.
- Treatment methods for kidney failure: Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/hemodialysis/. Accessed April 7, 2013.
- Hemodialysis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/genitourinary_disorders/renal_replacement_therapy/hemodialysis.html. Accessed April 7, 2013.
- Berns JS. Patient information: Hemodialysis (Beyond the Basics). http://www.uptodate.com/home. Accessed April 7, 2013.
- Kidney disease: Causes. National Kidney Foundation. http://www.kidney.org/atoz/content/kidneydiscauses.cfm. Accessed April 9, 2013.
- Kidney disease basics. National Kidney Disease Education Program. http://www.nkdep.nih.gov/learn/kidney-disease-basics.shtml. Accessed April 9, 2013.
- The kidneys and how they work. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/yourkidneys/index.aspx. Accessed April 9, 2013.
- Consequences of frequent hemodialysis: Comparison to conventional hemodialysis and transplantation. Transactions of the American Clinical and Climatological Association. 2011;122:124.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. April 12, 2013.
- Norby SM (expert opinion). Mayo Clinic, Rochester, Minn. April 18, 2013.
- About chronic kidney disease. National Kidney Foundation. https://www.kidney.org/kidneydisease/aboutckd.cfm. Accessed April 26, 2013.
- Albright RC (expert opinion). Mayo Clinic, Rochester, Minn. May 2, 2013.
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