Before your hemodialysis can start, an opening has to be made in your body so your blood can be accessed by the hemodialysis nurse and made to flow out and go back in. This opening is called a vascular access.
There are 3 main types of vascular access for hemodialysis.
Fistula: An artery in your forearm is sewed to a vein nearby.
Graft: An artery and a vein in your arm are joined by a U-shaped plastic tube under the skin.
Central venous catheter: A soft plastic tube (catheter) is “tunneled” under your skin and placed in a vein in your neck, chest, or groin. From there, the tubing goes into a central vein that leads to your heart.
You may have a little redness or swelling around your access site for the first few days. If you have a fistula or graft:
Taking care of the dressing (bandage):
Grafts and catheters are more likely than fistulas to become infected. Signs of infection are redness, swelling, soreness, pain, warmth, pus around the site, and fever.
Blood clots may form and block the flow of blood through the access site. Grafts and catheters are more likely than fistulas to clot.
The blood vessels in your graft or fistula can become narrow and slow down the flow of blood through the access. This is called stenosis.
Following these guidelines will help you avoid infection, blood clots, and other problems with your vascular access.
Call your doctor or nurse right away if you notice any of these problems:
Ateriovenous fistula; A-V fistula; A-V graft; Tunneled catheter
Updated by: Herbert Y. Lin, MD, PHD, Nephrologist, Massachusetts General Hospital; Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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