Dialysis Access for Hemodialysis

What Is Dialysis Access?

Dialysis access is a connection that allows blood to be removed from the body, filtered through a dialysis machine, and returned during hemodialysis treatments.

The most common types of dialysis access include:

Arteriovenous (AV) Fistula

An AV fistula is created by connecting an artery directly to a vein. It is generally considered the preferred form of dialysis access because it can provide long-term durability and lower infection risk.

Arteriovenous (AV) Graft

An AV graft uses a synthetic tube to connect an artery and vein when a patient's veins are not suitable for a fistula.

Dialysis Catheter

A dialysis catheter, sometimes called a dialysis port, is a tube placed into a large vein, typically in the neck or chest. Catheters are often used when dialysis is needed immediately or while waiting for a fistula or graft to mature.

Common Dialysis Access Problems

Patients may experience complications that affect blood flow and dialysis effectiveness.

Common issues include:

• Access narrowing (stenosis)
• Blood clots (thrombosis)
• Poor dialysis flow rates
• Access dysfunction
• Swelling of the arm or hand
• Infection
• Bleeding from the access site
• Central venous stenosis

Prompt evaluation can help prevent access failure and interruptions in dialysis treatment.

Dialysis Access Services We Offer

Depending on your condition, treatment may include:

AV Fistula Creation

Surgical creation of a durable dialysis access using your own blood vessels.

AV Graft Placement

Creation of dialysis access using a specialized synthetic graft.

Fistulogram

An imaging study used to evaluate blood flow and identify narrowing or blockage within a dialysis access.

Balloon Angioplasty

A minimally invasive procedure used to open narrowed areas and improve blood flow.

Thrombectomy

Removal of blood clots that may be preventing a fistula or graft from functioning properly.

Dialysis Catheter Placement

Placement of temporary or long-term dialysis catheters when immediate dialysis access is needed.

Signs Your Dialysis Access May Need Evaluation

Contact your healthcare team if you notice:

• Difficulty completing dialysis treatments
• Reduced dialysis machine flow rates
• Swelling around the access site
• Pain or tenderness
• Prolonged bleeding after dialysis
• Absence of the normal "thrill" or vibration in a fistula
• Changes in the appearance of your access

Early treatment may help preserve access function and avoid the need for replacement.

Why Choose BASS Vein Center

Patients throughout Contra Costa, Alameda, and Napa counties trust BASS Vein Center for vascular care because we offer:

• Board-certified vascular specialists
• Comprehensive dialysis access evaluation
• Ultrasound-guided vascular imaging
• Minimally invasive treatment options
• Multiple convenient East Bay locations
• Coordinated care with nephrologists and dialysis centers

Our goal is to help maintain reliable dialysis access while minimizing disruptions to your treatment schedule.

Frequently Asked Questions

What is the difference between a fistula and a dialysis catheter?

A fistula is created using your own blood vessels and is generally intended for long-term dialysis access. A catheter is placed into a large vein and is often used temporarily or when immediate access is required.

How long does an AV fistula last?

Many fistulas can function for years when properly maintained, though longevity varies by patient.

What is a fistulogram?

A fistulogram is a specialized imaging procedure used to evaluate blood flow through a dialysis access and identify narrowing or blockage.

Can a blocked dialysis access be repaired?

In many cases, narrowed or clotted dialysis access can be treated with minimally invasive procedures such as angioplasty or thrombectomy.

When should I call my doctor about my dialysis access?

You should seek evaluation if you notice swelling, pain, prolonged bleeding, reduced blood flow during dialysis, or changes in the vibration (thrill) of your access.