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Dialysis Access Procedures: AV Fistulas and AV Grafts - The Preferred Access Procedures

Dialysis and Types of Access Procedures

Overview

Hemodialysis is the process by which blood is filtered and run through a dialysis machine, fluid and waste products are removed and then the clean blood is returned to the body. Dialysis access procedures are the means to obtain the connection between the body and the dialysis machine. If the dialysis is a highway then access procedures are the on and off ramps. There are three types of hemodialysis access: AV fistula, AV graft, and catheters and another form of dialysis via fluid exchange in the abdomen, called peritoneal dialysis, uses a catheter. Thus there are two types of dialysis hemodialysis and peritoneal dialysis. And there are three types of hemodialysis access and one type of peritoneal dialysis access.

Why Dialysis is Done

Dialysis is done for patients whose kidneys are not well enough to remove waste products from their bodies. If dialysis is not performed, these patients, with little if any kidney function, build up poisonous waste products and eventually would die.

How hemodialysis works

To do hemodialysis, blood is taken from a blood vessel. The blood vessel blood is taken from must have a great deal of blood flow to make the process work efficiently. The best source of such blood flow is derived from an artery. The most common artery used is the ones located in the arm and typically at the wrist. It is not safe or practical to stick an artery, particularly as frequently as needed for hemodialysis (typically three times per week). Thus a means is needed to bridge between the high pressure and flow of the arterial system and the low pressure and slower flow of the venous system. This can be accomplished using natural, autogenous veins from the patient or using a synthetic graft. When the vein is used it is referred to as a fistula and when a graft is used it is called a shunt.

Normal anatomy of the artery and vein. The artery has high pressure and flow where as thevein has low pressure and slower flow

This figure depicts the connection between an artery and vein. It is called a fistula and has great flow for dialysis needs

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