Choosing Your Best Dialysis Access

Your dialysis access is your lifeline. It’s your connection to treatment and the key to feeling your best and maintaining your health. Depending on which dialysis treatment you’re receiving, you and your doctor may discuss your overall health, your lifestyle, your veins and accessibility, plus any history you’ve had with a previous access site.

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Taking care of your access site is essential

With any type of dialysis access, proper care and attention to cleanliness are extremely important. In order to ensure effective dialysis treatment, be sure to follow your nurse’s exact instructions for access site maintenance including cleaning, checking for infection, and regular flow monitoring.

Types of Dialysis Access

Arteriovenous (AV) fistula

Arteriovenous (AV) fistula

What it is

Healing time required before use

Which type(s) of dialysis it’s used for

Key considerations

Graft

Graft

What it is

Healing time required before use

Which type(s) of dialysis it’s used for

Key considerations

Hemodialysis catheter

Hemodialysis catheter

What it is

Healing time required before use

Which type(s) of dialysis it’s used for

Key considerations

Peritoneal dialysis catheter

Peritoneal dialysis catheter

What it is

Healing time required before use

Which type(s) of dialysis it’s used for

Key considerations

Questions to ask your doctor or nurse to find out which type of access is right for you

Which types of access am I eligible for?

You may have some flexibility depending on your chosen dialysis treatment, your veins and your overall health. A vein mapping test can help determine your eligibility for a fistula or graft.

If I have a hemodialysis catheter, can I switch to another type of access site?

If you have a catheter for hemodialysis, it’s recommended that you switch to a fistula or a graft if you’re eligible. Hemodialysis catheters can have a lower blood-flow rate and higher risk of infection. Therefore, a hemodialysis catheter is not recommended for the long term unless your doctor has determined that it is the best type of access for you.

What’s the risk of clotting or infection for my access type?

It’s important for you to understand the risks and considerations associated with the access types.
  • Fistulas and grafts have a lower risk of clotting or infection than hemodialysis catheters - which is why those particular catheters are not recommended for the long term on hemodialysis.
  • Peritoneal Dialysis Catheter - daily care of the peritoneal dialysis catheter is very important. Washing hands, applying local (topical) antibiotic cream and taking good care of the exit site as taught by your home therapy nurse is essential to preventing infections.

What should I expect for placement surgery and recovery?

Access placement is considered minor surgery and is often done on an outpatient setting. Healing times vary, based on the type of access site.

Other people I’ve talked to haven’t changed their access sites. Why should I?

Even if you are healthy and doing well with your current access site, it’s still important to ensure that you have the best type of vascular access for you. Being proactive and getting your best access site can help minimize your risk of infection.

Do I need a vein mapping test?

To help you and your doctor determine the best type of vascular access for you, you should schedule a vein mapping test if you havent had one already. The test analyzes your veins to help your doctor assess your best choice for an access site. This test may also be repeated after you’ve been on dialysis, as veins can improve after being on treatment.