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Hemodialysis access

If you need hemodialysis treatment, our surgeons can create an access point in your body to make your regular treatment easier. Your new access will replace a catheter, which is known to have higher rates of infection and clotting.

There are three different kinds of hemodialysis access.

Arteriovenous (AV) fistula

An AV fistula is the most effective type of hemodialysis access. To create one, your surgeon will connect an artery to a vein, usually in your arm. This connection will allow more blood to flow into the vein, which progressively will enlarge and strengthen it. Consequently, the vein will stand up better to the repeated needle sticks required for hemodialysis, and the process of removing waste from the blood will be faster because of the increased blood flow.

The fistula will need to heal over an extended period of time before it can be used as an access point. For more information about AV fistulas, visit our page about our department’s research on AV fistulas, sponsored by the National Institutes of Health.

AV graft

An AV graft is created when an AV fistula is not feasible, often because of weak or small veins. In this procedure, surgeons use a plastic tube to create the connection between the artery and vein. Like an AV fistula, an AV graft requires some time to heal.

An AV graft typically does not last as long as an AV fistula and is more prone to infections and clotting.

Venous catheter

A venous catheter is the third type of hemodialysis access a surgeon can create. The catheter is inserted into a vein in the neck, chest or in your leg near the groin. This is only a temporary solution for access because of numerous complications that can occur with a venous catheter. Surgeons typically insert a catheter for hemodialysis access when a patient requires dialysis treatment before an AV fistula or graft would have time to heal properly.

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