Dialysis Access


The kidney’s main job is to clean your blood. When kidneys begin to fail, blood is no longer being cleaned and waste and excess fluid build-up. This imbalance can lead to loss of kidney function, and if left untreated, eventually death. While there is no cure for kidney failure, dialysis can filter the blood to help slow the progression of the disease and keep the body working the best it can.

Some diseases that cause chronic kidney disease include: Diabetes, high blood pressure, conditions involving the urinary tract (enlarged prostate, kidney stones, and some cancers), recurrent kidney infections or inflammation, and inherited kidney diseases.

Blood is filtered through hemodialysis or peritoneal dialysis processes. 

Hemodialysis – This procedure, performed several times a week by medical professionals, uses a manmade filter or dialyzer in a machine to clean the blood. The blood that goes through the dialyzer is drawn and returned from a special blood vessel called an access. 

Hemodialysis uses two types of access – a fistula or a graft.

  • A fistula is created by connecting a vein in the arm to a nearby artery. The vein enlarges and allows easy access. The challenge is that it may be weeks or months before the fistula is ready to be used for dialysis access.

  •  A graft is a manmade tubing that is sewn between an artery and a vein, usually in the arm, allowing blood to flow rapidly. Grafts are generally ready for use in dialysis in just a few weeks. 

One characteristic of a hemodialysis access is a thrill. The large blood volume passing quickly through the access can be felt through the skin. It feels like a vibration. If for some reason you can’t feel the thrill, call Vascular Tyler right away.

Peritoneal Dialysis – This treatment uses a natural peritoneal membrane that lines the abdominal cavity. Dialysate solution fills the cavity through a catheter that is often permanently placed near the belly button. The process of draining the solution through the catheter several times a day and replacing it with fresh dialysate is called the exchange.  

Peritoneal dialysis (PD) exchanges can be done at home or work and takes approximately 30 minutes. Continuous ambulatory peritoneal dialysis (CAPD) is done every four to six hours during the day, and continuous cyclic peritoneal dialysis (CCPD) is performed at night while you sleep using a machine called a cycler. 

Complications that are possible with hemodialysis include allergic reaction, blood loss, infection, and low blood pressure. Complications for peritoneal dialysis include blockage of the catheter, blood sugar problems (if you have diabetes), infection of the catheter site, and peritonitis (infection inside the abdomen).

You will probably be discharged the same day as your procedure, and you should arrange a ride home once released. Recovery should take a week, and a follow-up appointment is usually scheduled two weeks after surgery.

Guidelines to follow during recovery are:

  • Avoid lifting objects more than 10 pounds for a week or otherwise instructed

  • Do not drive until cleared to do so

  • Keep the incision or puncture site clean and dry

  • Take medications as prescribed


The Patient Experience

Dr. Robbins looked at my imaging and made an appointment that same day for me to come in. At Vascular Tyler, it’s just like a family environment every time I come in here. If I have to go the doctor’s (office), this is where I want to go.
L. Cunningham, Patient
We don’t want to spend a whole lot of time with rehabilitation or in some sort of medical facility, so it was great discovering that there’s only little or no downtime. It was a matter of hours instead of days or weeks.
B. Finch, Patient
I had excruciating pain and was told I needed a knee replacement. But Dr. Robbins said I just need vascular surgery. They gave me relief from my pain, and they’re kind and interested in you as a patient and a person. This is the place to come.
M. Finch, Patient

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