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.