Living With Dialysis Access

What to Expect, How to Care for It, and When to Seek Help

Dialysis access is a lifeline for patients living with chronic kidney disease. Whether you have an AV fistula, AV graft, or dialysis catheter, proper care is essential to ensure safe and effective treatments. Understanding how your access works—and how to protect it—can help prevent complications and keep you feeling your best.

Types of Dialysis Access

There are three main forms of dialysis access. Your nephrologist and vascular specialist select the best option based on your health, veins, and long-term needs.

1. AV Fistula (Arteriovenous Fistula)

A fistula is created by connecting an artery and vein in your arm. It is considered the gold standard because it:

• Offers the best blood flow
• Lasts the longest
• Has the lowest risk of infection

2. AV Graft

A graft uses a soft synthetic tube to connect an artery to a vein. It is recommended when veins are not strong enough for a fistula.

• Matures faster than a fistula
• Useful when veins are small or damaged

3. Dialysis Catheter

A catheter is a flexible tube placed into a large vein in the neck or chest. It is typically used for short-term dialysis or emergencies.

• Highest infection risk
• Not intended for long-term use

How to Care for Your Access

Good access care protects your lifeline and helps avoid infections, clotting, and other complications.

Daily Care Tips

• Wash the access area daily with soap and warm water
• Check for a “thrill” — a buzzing vibration that means blood is flowing
• Avoid scratching, rubbing, or bumping the access site
• Keep the area clean and dry between dialysis sessions

Protecting Your Access

• Never let anyone draw blood or take blood pressure on your access arm
• Avoid wearing tight sleeves, heavy jewelry, or watches on the access arm
• Do not sleep on the arm with your access
• Stay hydrated unless your dialysis team advises otherwise

What to Watch For

Early warning signs help prevent serious problems like clotting, infection, or access failure.

Call your dialysis team or vascular specialist if you notice:

• The thrill or bruit becomes faint or stops
• New swelling, redness, or warmth
• Bleeding that doesn’t stop after dialysis
• Pain, tenderness, or hardness around the access
• Drainage, pus, or signs of infection
• Hand numbness, weakness, or coolness

These symptoms may indicate clotting, infection, or a narrowing (stenosis) that needs urgent treatment.

How Vascular Specialists Help Protect Your Access

Your dialysis access requires periodic monitoring—just like a car needs routine maintenance.

Common Access-Saving Procedures

• Angioplasty: Opens narrowed veins to improve blood flow
• Stenting: Keeps a narrow area open when needed
• Thrombectomy: Removes clots that block the access
• Ultrasound evaluation: Helps identify early problems

When issues are caught early, most access problems can be repaired the same day with minimally invasive treatments.

Living Well With Dialysis

Dialysis can feel overwhelming at first, but with the right support, most patients live active, fulfilling lives. Taking good care of your access helps ensure consistent treatments and fewer complications.

Helpful Day-to-Day Tips

• Follow your dialysis schedule closely
• Eat a kidney-friendly diet recommended by your care team
• Take medications as prescribed
• Stay active with safe exercises like walking or stretching
• Stay informed—ask questions and involve your family or support system

When to See a Vascular Specialist

You should schedule an appointment if you have difficulty during dialysis, changes in your bruit or thrill, or any signs that your access isn’t working as usual.

Your Dialysis Access Is Your Lifeline

With proper care and regular monitoring, dialysis access can function well for years. Our vascular and endovascular specialists are here to protect your access, treat complications early, and help you stay healthy and confident during dialysis.