Dialysis is a procedure that slowly removes blood from a patient’s body, circulates it through a dialysis machine that removes toxins, excess water and other impurities and returns the blood to the patient. Essentially, it does the work of the kidneys when a patient’s kidneys are not healthy enough to function properly. Dialysis access surgery creates an easy access point to the patient’s bloodstream—usually in the arm, leg or neck underneath the skin—that is necessary for long-term dialysis treatment.
Dialysis access surgery is appropriate for certain patients with chronic kidney failure. Also known as renal failure or end-stage renal disease, kidney failure usually results from other conditions that cause irreparable damage to the kidneys, including diabetes, high blood pressure and certain autoimmune disorders.
Common signs of kidney failure include:
- Muscle cramps
- Swelling around the feet and ankles
- Loss of appetite
- Nausea and vomiting
There are several surgical methods that can be used to establish dialysis access through a vein or catheter, including:
- Arteriovenous (AV) fistula – Often considered the best option for dialysis access, an AV fistula takes a segment of vein in the arm or leg and attaches it to a nearby artery.
- Arteriovenous (AV) graft – This method uses a prosthetic graft to connect an artery and vein in the arm or leg.
- Venous catheter (tunneled dialysis catheter) – A less common approach, a venous catheter involves attaching a small tube to a large vein in the neck, leg or chest.
What to Expect
Dialysis access surgery is a minimally invasive procedure that can be performed under local or general anesthesia. Depending on what surgical approach is taken, it may take a few weeks or months for the access vein to “mature” and become ready for dialysis equipment (venous catheters are ready for immediate use, however).
As is the case with all medical procedures, dialysis access surgery comes with some measure of risk. Possible complications of this surgery include excess bleeding, infection and reduced blood flow around the dialysis access point.
Dialysis is an essential, life-saving treatment for patients who have end-stage kidney failure and are not candidates for kidney transplantation. Tampa General Hospital features board-certified vascular surgeons who routinely perform dialysis access procedures and collaborate with nephrologists, radiologists, endocrinologists and other experts to ensure world-class outcomes for patients with kidney failure.