Kidney Disease | Dialysis Access and Care
What is End Stage Renal Disease?
End stage renal disease or ESRD is when the kidneys are no longing functioning enough to sustain life. At this point patients require dialysis ignorer to do the of the kidneys. Dialysis is the process of filtering the blood of electrolytes and fluid through a machine, a process that is normally done by the kidneys.
What are my options for dialysis access?
- An Arteriovenous (AV) Fistula is the gold standard for hemodialysis access in ESRD surgically connecting an artery and a vein (usually in the arm) to create a strong, durable pathway for blood filtration, allowing for reliable, long-term dialysis while reducing risks of infection and clotting compared to other access types, though it requires several weeks to "mature" and can pose cardiovascular challenges.
- An Arteriovenous (AV) graft for End-Stage Kidney Disease (ESKD) is a surgically created pathway, using a synthetic tube to connect an artery and vein, providing durable access for hemodialysis when natural vessels aren't suitable for an AV fistula, offering faster readiness (weeks) but higher infection/clotting risks than fistulas, though it's a common choice for those needing quick access or with poor veins, lasting several years with good care.
- A tunneled hemodialysis (HD) catheter provides essential vascular access, acting as a bridge until a permanent fistula/graft matures or serves as a long-term option when other accesses fail. Inserted under ultrasound/fluoroscopy into a large vein with a subcutaneous tunnel or cuff for stability and infection control, it requires meticulous care to prevent complications like infection and clotting.
According to KDOQI national guidelines, the best method for hemodialysis is through a fistula, which a surgically created connection between a vein and a artery.
