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Taking care of your vascular access for hemodialysis

Description

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.

Alternative Names

Ateriovenous 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 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:

References

U.S. Department of Health and Human Services. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). Vascular access for hemodialysis. NIDDK.NIH.gov. Updated May 2014. Accessed December 28, 2016. kidney.niddk.nih.gov/kudiseases/pubs/vascularaccess/vascularaccess_508.pdf.

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: 11/11/2016
Reviewed By: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana. 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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