Trusted care for your dialysis access
- Overview
- Dialysis access placement
- Managing your dialysis access
- Benefits of dialysis access care
Before your dialysis access is placed, your doctor may recommend a vein mapping test. This simple, noninvasive ultrasound helps assess the condition of your veins and determine which access type will work best for you. We offer vein mapping at our centers to support this step in your care.
Once you and your nephrologist have decided on an access type that is best for your treatment plan, schedule an appointment at one of our centers. We offer minimally invasive, nonsurgical access placement in a comfortable outpatient setting, allowing you to return home the same day. Availability of placement services may vary by center location.
Managing your dialysis access
Dialysis access management keeps your access site working so you can quickly return to your scheduled dialysis treatment. We offer minimally invasive procedures that help open up your veins to prevent clotting and avoid hospital stays. All procedures are done in a comfortable outpatient setting, so you can go home the same day.
You doctor may perform one of the following procedures to help manage and care for your access:
- Angioplasty and stent placement: If you have stenosis, or narrowing of the blood vessels, you may notice that your access gets smaller over time. An angioplasty can help. This minimally invasive procedure restores blood flow to your AV fistula or graft. Your doctor may also place a stent (a small mesh tube) to keep your blood vessel open long term.
- Thrombectomy and thrombolysis: These declotting procedures are performed when a fistula or graft has a blood clot. Various techniques may be used to remove the clot from the access in order to restore blood flow.
- MILLER1 procedure for steal syndrome: If you've experienced coldness, numbness, or pain in your hand during dialysis treatment, you might have a condition called steal syndrome. The MILLER procedure restores blood flow by placing a small band around your vein.
A healthy access site is essential for dialysis treatment. If you notice any of these signs or symptoms, contact your doctor immediately:
- Difficulty inserting needles
- Pain or swelling at your access site
- Weak pulse
- Signs of infection, like redness, warmth, or drainage
- Clotting, or a sudden loss of access function
- Pitch changes or whistles during dialysis
Preparing for a dialysis access procedure depends on the type of procedure you're having. You'll meet with your doctor to review your health history and have a physical exam. Your doctor may perform a vein mapping, do an X-ray, or order bloodwork. You may be asked to bring a list of your medications to your appointment. We'll guide you through every step to make sure you feel comfortable and confident in our care, addressing any potential side effects and answering any questions you have.
Recovery after a dialysis access procedure depends on the type of procedure you're having. Your doctor will explain what you can expect before, during, and after your procedure.
If you're having a dialysis access placed, your access may take a few days up to a few weeks to mature:
- PD catheters require a few days to 2 weeks to heal.
- Fistulas need 6-8 weeks to mature.
- Grafts need 2-3 weeks to heal.
- HD catheters are ready for use immediately. However, these are not recommended unless medically necessary.
If you're getting a dialysis access management procedure, you should avoid heavy lifting for 24 hours after the procedure and can resume normal activities after that.
If you already have an HD catheter, you may be able to switch to a permanent option, like a fistula or graft. HD catheters are generally not recommended for long-term use because they have a higher risk of infection and blood clots. Talk to your doctor about switching to a fistula or graft.
If you are on peritoneal dialysis, you can continue to use your PD catheter for as long as you're prescribed the treatment. If you are preparing to switch to hemodialysis, talk to your doctor about having a fistula or graft placed.
Our centers take most insurance plans. However, always check with your insurance provider to understand what your plan covers.
