What is dialysis?
Dialysis is a procedure performed routinely on patients who have acute or chronic kidney disease, or end-stage renal disease. Kidney failure is most often irreversible, and options are dialysis or kidney transplant. In these patients, their kidneys have stopped functioning as they used to. The purpose of the kidneys is to cleanse the body of waste products, regulate the fluid volume of the body and promote removal of the appropriate number of electrolytes and chemical substances. The process of dialysis is to do the job of the kidneys by cleansing the blood and removing waste products and excess fluid. In order to be hooked up to the dialysis machine, a blood access site must be created, that can withstand frequent needle puncture; these sites can be temporary or long term.
What are the types of dialysis access surgeries?
There are three types of dialysis access: temporary catheter, AV fistula, and AV graft.
- Temporary Catheter: During this procedure, a thin flexible tube called a catheter is placed into a large vein in the neck. This catheter can be used a maximum of 3 months, so long term dialysis patients will require something else eventually. Also, because this catheter is placed directly into the bloodstream, there is a high risk of infection.
- AV fistula: During this procedure, a small incision is made, and an artery and a vein are sewn together. About 6 weeks following the procedure, the vein will increase in size and become thicker and tougher.
- AV graft: During this procedure, two small incisions are made in the arm and a cylinder like tube called a graft is inserted under the skin. One end of the graft is sewn to the artery and the other end to the vein. Again, this increases the size of the vein and it becomes tougher and thicker, with rapid blood flow from the artery to the vein.