Overview

Dialysis Access

What is a fistula?

A fistula involves joining a vein and an artery to form a bigger, stronger blood vessel.  The forearm of your non-dominant hand is the preferred site for the fistula.  You may have a special scan called a venogram prior to surgery so the doctor can determine where to place the fistula.  The formation of the fistula will be performed in surgery under a general or local anesthetic.  Ideally the vascular access surgery is performed well in advance of its anticipated need to allow the fistula to develop and mature. 

Why do you need a fistula?

Hemodialysis is a therapy in which the blood is filtered for patients with end-stage renal disease.  During hemodialysis the dialyzer machine replaces the patient's kidney function by removing waste prodcuts from the blood.  In order to perform the hemodialysis, the patient must have venous access, which requires a surgical placement of either a native fistula (also known as an AV fistula which is created by joining an artery and a vein together) or by using a synthetic graft.   Blood is removed from the patient, circulated through a dialyzer machine, and returned back to the patient.   A highly functioning dialysis access is the patient’s avenue for optimal hemodialysis therapy.

In certain cases an emergency dialysis access may be required.  If access is needed prior to the development of the permanent access, a temporary tunnel catheter may be placed.  This type of access is temporary in nature due to the high risk of infection.

View our Video on Dialysis Access