Dialysis Access

Dialysis access is a surgically made connection or tube that allows dialysis to work properly.

• For haemodialysis, blood is taken out, cleaned by a dialysis machine, and returned to your body
• For peritoneal dialysis, dialysis fluid goes into your abdomen to clean your blood inside your body

1. Arteriovenous (AV) Access: Haemodialysis

An arteriovenous (AV) access joins an artery and a vein, usually in the arm.

Types of AV Access

• Native AV fistula (open surgery)
  Uses your own vein
• AV graft (open surgery)
  Uses a soft plastic tube to join the artery and vein
• Endovenous AV fistula
  Created using a catheter inside the blood vessels (no open cut)

AV access needs time to heal and mature before dialysis can start.

2. Peritoneal Dialysis Access: Tenckhoff Catheter

A Tenckhoff catheter is a soft tube placed into your abdomen (tummy).

It can be inserted using:

• Laparoscopic surgery (small cuts and camera)
• Open surgery (one larger cut)

This catheter stays in place for ongoing peritoneal dialysis.

• The procedure is done in hospital
• You will have local or general anaesthetic
• Most people go home the same day or after a short stay

Your doctor will choose the best access for you based on your health and veins.

Haemodialysis (AV Access)

• Needles are placed into the access
• Blood flows to the dialysis machine
• The machine cleans the blood
• Clean blood is returned to your body

Peritoneal Dialysis (Tenckhoff Catheter)

• Dialysis fluid flows into your abdomen
• Waste and fluid move into the fluid
• The fluid is drained out and replaced

All procedures have risks. Your doctor will discuss these with you. Possible risks Include:

• Infection
• Bleeding or bruising
• Blood clots
• Poor healing
• Damage to nearby blood vessels or organs
• Access not working properly

Seek help early if you notice problems.

General Care

• Keep the area clean and dry
• Follow dressing instructions
• Take pain relief as advised
• Attend all follow-up appointments

AV Fistula or Graft Care

• Check daily for a vibration (thrill)
• Keep the arm clean
• Do exercises if advised
• NO blood pressure or blood tests on that arm
• NO tight clothing or heavy lifting
• Do NOT sleep on the access arm

Peritoneal Dialysis Catheter Care

• Keep catheter secured and covered
• Clean exit site as shown by your nurse
• Do not pull or twist the catheter
• Avoid heavy lifting until healed

Get Medical Help Urgently If You Have:

• Redness, swelling, pain, or discharge
• Fever or chills
• Heavy bleeding
• AV access stops vibrating
• Catheter damage or catheter comes out
• Cloudy dialysis fluid or tummy pain (PD)