How do I know if the graft is functioning effectively?
There are two signs that indicate a dialysis access site is functioning well. When you slide your fingertips over the site you should feel a gentle vibration, which is called a “thrill.” Another sign is when listening with a stethoscope a loud swishing noise will be heard called a “bruit.” If both of these signs are present and normal, the graft is still in good condition. If not, there may be a narrowing within the graft as a result of blood clot collection. If there is bruising or discoloration close to the graft site, this could indicate that part of the graft wall was punctured and may require repair as well. The site may need to be reopened and repaired, or it may be possible to insert a thin flexible tube called a catheter through the site and use a balloon to widen the opening of the graft and improve blood flow.
What are signs or symptoms I should report?
It is very important to protect your dialysis access site! Do not compress the arm containing the site with tight clothing or jewelry and do not rest anything heavy against it. Remember that it should never be used for routine blood draws, as an IV site for medications or fluids, or as an arm for blood pressure cuff readings. Signs or symptoms that are potentially dangerous and need to be reported include:
- Signs of infection at the access site, such as redness, swelling, or drainage of pus
- A large bruise spreading away from the graft site following a recent dialysis session
- A pulsating hard knot under the skin
- Lack of bruit or thrill
- Coldness, paleness, aching, or tingling in the extremity with the access site