- A catheter in your neck / groin—temporary, because the possibility of infection is high.
- A tunnelled catheter in chest / thigh – can be kept for longer periods, more resistant to infection.
- An AV fistula—taking a piece of a vein from your arm or leg and sewing it into a nearby artery, making the vein large and thick so that it can be punctured during dialysis. The best option because it has the lowest risk of infection. A fistula takes upto 6 weeks – 8weeks from the time of surgery to be ready for use for dialysis.A good working fistula can last upto 6 to 8 years.
- An AV graft—the sewing of an artificial tube between an artery and vein in your arm or leg. The preferred option if your veins are too small for an AV fistula. AV grafts are more prone to infection because they are not formed from natural tissue. A V graft s can be used for dialysis with 1 – 2 weeks with some grafts that can be used as early as 48 hrs after surgery.
- Peritoneal dialysis—placement of a small tube, called a cannula, in your abdomen to allow the use of the lining of the abdomen (peritoneum) to filter your blood. It requires several “exchanges” every day: you introduce and remove fluid through the tube. A convenient option because you perform the dialysis therapy at home, but infections sometimes occur and the tube can become clogged.
Timing of dialysis access
Failure of access
Fistula Salvage procedures
Central Vein angioplasty
Tips to maintain your dialysis access
- Good local hygiene
- Avoid pressure or blood sampling in the limb
- Soft Ball exercise
- Regular follow up with your vascular surgeon at least once in three months if you have undergone a salvage procedure
- Control blood pressure, Low blood pressure can cause blockage of your fistula