Taking care of your vascular access for hemodialysis
You have a vascular access for hemodialysis. Taking good care of your access helps make it last longer.
Follow your health care provider's instructions on how to care for your access at home. Use the information below as a reminder.
Arteriovenous fistula; A-V fistula; A-V graft; Tunneled catheter
What Is a Vascular Access?
A vascular access is an opening made in your skin and blood vessel during a short operation. When you have dialysis, your blood flows out of the access into the hemodialysis machine. After your blood is filtered in the machine, it flows back through the access into your body.
Know What Type of Vascular Access You Have
There are 3 main types of vascular accesses for hemodialysis. These are described as follows.
Fistula: An artery in your forearm or upper arm is sewn 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.
When You First Leave the Hospital
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):
Problems to Watch For
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.
Day-to-day Care of Your Vascular Access
Following these guidelines will help you avoid infection, blood clots, and other problems with your vascular access.
When to Call the Doctor
Call your provider right away if you notice any of these problems:
Kern WV. Infections associated with intravascular lines and grafts. In: Cohen J, Powderly WG, Opal SM, eds. Infectious Diseases. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 48.
National Institute of Diabetes and Digestive and Kidney Diseases website. Hemodialysis. www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis. Updated January 2018. Accessed October 25, 2018.
Yeun JY, Ornt DB, Depner TA. Hemodialysis. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 65.
Review Date: 10/15/2018
Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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