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Vascular Access

When a person chooses hemodialysis as their treatment option, they see a vascular access surgeon. It is important to plan early for an access because it is needed for hemodialysis treatments.

Types of Vascular Access for Hemodialysis

There are three types of vascular access used for hemodialysis.

  • Two types are intended for long-term use and are recommended by health care providers because these have the lowest risks. These types of access include a fistula and a graft.
  • The third type, a hemodialysis catheter, is for short- term use.

Planning for a Vascular Access

  • A fistula (AVF) is made during an outpatient surgery. An artery is connected to a vein to make the vessel larger and stronger. An access is usually “mature” or large enough to be used for dialysis after 6 to 8 weeks.
  • A graft (AVG) is also made during an outpatient surgery. An artificial tube is used to connect an artery to a vein to make a vessel large enough for dialysis. This tube is tunneled under the skin by a surgeon. It may be ready to use for dialysis within a few days to two weeks after the surgery.
  • A tunneled hemodialysis catheter is a tube placed into a large vein in the neck or groin. It is placed close to the heart. The surgeon “tunnels” it under the skin. This type of dialysis access is usually used for a short time. It is placed when someone needs urgent dialysis.
  • If someone decides to have hemodialysis, they should see a vascular surgeon. The surgeon decides if they are a candidate for a fistula or graft. The kidney doctor (nephrologist) can help schedule this appointment before hemodialysis is needed. Giving the access time to mature helps prevent problems.
  • If you or your loved one plans to start hemodialysis, ask the kidney doctor (nephrologist) for more information on vascular access.