A dialysis access is a site on a person's
body created so that blood or other fluids can be removed, filtered, and
returned to the body during dialysis. Dialysis is a process that performs the
work of healthy kidneys for people who have kidney failure.
dialysis can begin, the doctor has to create a dialysis access. For
hemodialysis, the access is the place where the dialysis needles are inserted
to send the blood to and from the dialysis machine. In peritoneal dialysis, the
access is the place where a catheter is connected so fluid can flow into and
out of the belly.
Depending on the type of dialysis, the doctor
Attach an artery to a vein, usually in the
lower arm. This is called a fistula. After the fistula is healed, the dialysis
needles can be put directly into it. Fistulas tend to be stronger and less
prone to infection than grafts.
Implant a tube (graft) under the
skin of an arm or leg that connects an artery and a vein. The dialysis needles
can then be put into the graft for hemodialysis. A graft is a good choice if
the person has small veins or other problems.
Place a tube
(catheter) in the belly for peritoneal dialysis.
Usually, the doctor has to prepare the dialysis access
weeks to months before it is needed. This gives the access time to heal. If a
person needs emergency dialysis, the doctor may create a temporary access by
inserting a catheter into a vein in the neck, upper chest, or groin.
Anne C. Poinier, MD - Internal Medicine & Tushar J. Vachharajani, MD, FASN, FACP - Nephrology
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