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Hemodialysis access - self care

An access is needed for you to get hemodialysis. Using the access, blood is removed from your body, cleaned by a dialyzer, then returned to your body.

Usually the access is put in a person's arm. But it can also go in your leg. It takes a few weeks to a few months to get an access ready for hemodialysis.

Taking good care of your access helps make it last longer.

Prevent infection in your access.

Keep your access clean. Wash the access with soap and water every day to decrease your risk of infection.

Do not scratch your access. If you scratch open your skin at the access, you could get an infection.

  • Avoid bumping or cutting your access.
  • Do not lift anything heavy with the arm with the access.
  • Do not dig with the arm with the access.
  • Use your access for hemodialysis only.
  • Do not let anyone take your blood pressure, draw blood, or start an IV in the arm with the access.

Keep blood flowing through your access.

  • Do not sleep or lie on the arm with the access.
  • Do not wear clothes that are tight around the arms or wrists.
  • Do not wear jewelry that is tight around the arms or wrists.

Check your access.

Check the pulse in your access arm. You should feel blood rushing through that feels like a vibration. This vibration is called a “thrill.”

Have the nurse or technician check your access before every dialysis.

When to call the doctor

Call the doctor if:

  • You have any signs of infection, including redness, pain, pus, drainage, or you have a fever over 101 degrees.
  • You do not feel a pulse at your access.

Alternate Names

Kidney failure - chronic-hemodialysis access; Renal failure - chronic-hemodialysis access; Chronic renal insufficiency - hemodialysis access; Chronic kidney failure - hemodialysis access; Chronic renal failure - hemodialysis access; dialysis - hemodialysis access

References

U.S. Department of Health and Human Services. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). Vascular access for hemodialysis. http://kidney.niddk.nih.gov/kudiseases/pubs/vascularaccess/vascularaccess_508.pdf. Accessed September 8, 2013.

Silva MB Jr, Choi L, Cheng CC. Peripheral arterial occlusive disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:1725-1784.

Update Date: 9/8/2013

Updated by: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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