A Handy Guide to Dialysis Access Surgery Procedure

The function of the kidneys is to keep the blood away from the wastes. However, when they fail, they can perform this function no more. Dialysis access methods that work actually takes over the responsibility of keeping the blood clean. If you are suffering from a chronic kidney disease, but not have the kidney failure yet, you should consult with your doctor about which type of dialysis is best for you. The type of dialysis s/he recommends, will help in ascertaining the type of dialysis access you need. There are two kinds of dialysis— Hemodialysis and Peritoneal Dialysis.


Hemodialysis is a type of dialysis that is performed thrice a week and it takes about 3 to 5 hours. Two needles are injected into your hemodialysis access, blood flows via one needle and connecting tube to an artificial kidney (dialyzer) where the blood is being cleaned. Then it returns to your body via the second tube and needle.

Before the doctor can begin with hemodialysis, they must create a way to access your bloodstream. This is deemed to be the permanent access so that it can be used in every dialysis section. There are different types of access created during hemodialysis which includes:

  1. Fistula

This is created by joining one of the arteries to one of the veins located in the lower arm. When blood flows into that vein, it enlarges it. This access helps in frequent access for each dialysis session. It may take about 6 to 12 weeks to thicken the vein wall and the fistula to form and mature. It may not clot easily like other dialysis access methods.

  1. Shunt/Graft

It uses a piece of a synthetic tube which is sewn between an artery and a vein if the fistula is absent. The blood flows via the graft from the artery to the vein. The tube can be used frequently for placing the needle and blood access during hemodialysis. There is no need for the graft to develop like fistula, so it can be used for about 3 to 8 weeks after placement.

  1. Hemodialysis Catheter

If not used for permanent access, a hemodialysis catheter can be used on a temporary basis if a kidney disease is involved and other access has been unobtainable. In this case, a catheter is placed in the neck’s vein (jugular vein), chest (subclavian vein), or leg (femoral vein). Dialysis catheter can be also useful for patients who need dialysis while their permanent access is developing.

Peritoneal Dialysis

It is a technique which is used to eliminate waste from the blood via fluid instillation into the abdominal cavity for several hours after which it is removed via a Peritoneal Dialysis Catheter. It is a special tube which is placed, during a surgical procedure, into the abdomen which lets the instillation and evacuation of fluid used in peritoneal dialysis. The placement of the catheter is usually done 10 to 14 days before the dialysis starts.