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Arteriovenous Fistulae for Dialysis

Dialysis is an artificial method of purifying the blood in individuals with kidney failure. It helps in removing the impurities and waste products from the blood. Dialysis access is a method of gaining access into the bloodstream through blood vessels for dialysis.

During dialysis your physician will use the dialysis access to remove some amount of blood from the body which is allowed to circulate in the dialysis machine to remove the impurities, regulate body water and maintain electrolyte balance. Once the blood is purified in the dialysis machine it is returned to your body through the dialysis access.

Selection of dialysis access is very important because selecting the access area with decreased circulation may result in inadequate blood flow. Certain conditions such as atherosclerosis and hardening of arteries may limit the blood flow and this is more common in legs than arms. Therefore often physicians may have dialysis access through arms.

Before creating dialysis access your vascular surgeon may order blood flow tests in arms and legs such as ultrasound, X-ray and venogram to check if the veins are larger to use a fistula.
Dialysis can be performed using two different methods, peritoneal dialysis and hemodialysis. Peritoneal uses peritoneal membrane, the lining of your abdomen whereas hemodialysis uses a special type of filter to filter the blood and to get rid of harmful wastes, extra salt and water.

Permanent access is surgically created by an arteriovenous fistula (AVF)

AV fistula is created by joining a large vein under the skin to a nearby artery. The large vein is divided and stitched to the opening made at the side of artery. As a result blood flows down the arteries into the hand. The blood which flows in the divided vein will return to the heart through other veins and the remaining blood in the artery will flow to the hand.

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