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Dialysis and Vascular Access - Learn the Basics

Know that your kidneys perform various essential functions to sustain your life. They balance your body’s chemistry by continuously flushing impurities and cleaning out the blood. Plus, they play an important part in regulating blood pressure and filtering fluid quantity out of your body.


If kidneys fail either due to a chronic disorder such as ESRD or acute kidney injury, you have two options to consider;

Though the best way to deal with the medical condition is to consult your doctor or a specialist like Dr. Elizabeth Pensler, you can do some research to choose the right treatment. Here is a primer on dialysis and vascular access to help you understand the basics.



Types of Dialysis


Hemodialysis

Hemodialysis is a process in which a doctor accesses the bloodstream via a connection between a vein and an artery. This is known as vascular access. Your blood circulates between a machine and a connection outside the body. It is an effective way to cleanse the blood.


Your doctor may perform ongoing hemodialysis in your home or at an outpatient dialysis center. If you’re hospitalized, your doctors may also perform the treatment in an inpatient setting.


Peritoneal Dialysis

The process refers to circulating a cleaning solution into your abdomen lining (called the peritoneum). It typically cleans the blood. Doctors access the peritoneum via a catheter in the abdomen.


How to Establish and Maintain Vascular Access


Establishing Access

As a new patient to hemodialysis, you must undergo a lengthy surgical procedure to establish vascular access. The access can be of three types:


Arteriovenous Fistula

It is a direct connection between your vein and an artery and a vein. Doctors usually establish it on the surface of arms.


Arteriovenous Graft

It is a similar connection that uses a Gortex-like material to connect the vein and artery.


Tunneled Catheter (subcutaneous)

A connection is established through a tube doctors insert beneath the skin.


New patients of peritoneal dialysis must have access through a process that places a soft catheter in their abdomen to connect to the peritoneal cavity to perform the dialysis. Doctors can also establish temporary vascular access through a venous catheter if you have had an acute kidney injury.


Maintaining Access


Over time, issues may arise at access points requiring skilled and prompt medical attention. Graft and fistula access points can develop a clot or fail to function. If you’re a patient of peritoneal dialysis, you may develop issues if your abdominal Catheter develops holes or becomes malpositioned.

Your medical professional may offer the following:

  • Graft creation and arteriovenous fistula

  • Fistulograms

  • Dialysis catheter placement and maintenance

  • graft declot or arteriovenous fistula

  • Endovascular angioplasty

  • Venography

  • Transplant renal biopsy

  • Infusion catheter management

  • Peritoneal Dialysis Placement

  • Integrated surgery

  • Dialysis ultrasound

  • Dialysis clinical trials

Summing Up


In conclusion, vascular access and dialysis are one way to reach your bloodstream for hemodialysis. Once access is established, the blood travels through the delicate tubes of the machine or passes through a filter- dialyzer. The minor surgery helps you purify the blood.

Links


https://www.uofmhealth.org/conditions-treatments/kidney/dialysis-and-vascular-access

https://www.kidney.org/atoz/content/hemoaccess#:~:text=A%20hemodialysis%20access%2C%20or%20vascular,placed%20by%20a%20minor%20surgery.


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