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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, usually referred to as an access. It is the point where blood is removed from your body for dialysis and then returned. The surgical access needs time to heal before you begin hemodialysis treatments.
Three types of access are currently 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.
- Treatment methods for kidney failure: Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/Kudiseases/pubs/hemodialysis. Accessed Dec. 5, 2008.
- Dialysis in the treatment of renal failure In: Fauci AS, et al, eds. Harrison's Principles of Internal Medicine. 17th ed. United States of America: The McGraw-Hill Companies Inc.; 2008. http://www.accessmedicine.com/popup.aspx?aID=2881062&print=yes. Accessed Aug. 24, 2008.
- Hemodialysis. National Kidney Foundation. http://www.kidney.org/ATOZ/atozItem.cfm?id=35. Accessed Aug. 24, 2008.
- Berns JS. Patient information: Hemodialysis. http://www.uptodate.com/home/index.html. Accessed Aug. 26, 2008.
- Berns JS. Patient information: Renal replacement therapy. http://www.uptodate.com/home/index.html. Accessed Aug. 26, 2008.
- Berns JS. Patient information: Chronic kidney disease. http://www.uptodate.com/home/index.html. Accessed Sept. 10, 2008
- Kliger AS. Frequent nocturnal hemodialysis - A step forward? Journal of the American Medical Association. 2007;298:1331.
- Mailloux LU. Dialysis modality and patient outcome. http://www.uptodate.com/home/index.html. Accessed Aug. 26, 2008.
- Ricci Z, et al. Dose and efficiency of renal replacement therapy: Continuous replacement therapy versus intermittent hemodialysis versus slow extended daily dialysis. Critical Care Medicine. 2008;36(suppl):S229.
- McFarlane PA, et al. The quality of life and cost utility of home nocturnal and conventional in-center hemodialysis. Kidney International. 2003;64:1004.
