Renal Access Surgery

What is renal access surgery?

People who are diagnosed with kidney failure require dialysis to remove impurities from their blood and help balance the fluid and electrolyte levels in the body. Renal access surgery helps prepare people diagnosed with kidney failure for dialysis.

There are different types of dialysis access, namely:

  • Central venous catheter (CVC) During this procedure, a flexible, long, plastic, y-shaped tube called a catheter is inserted through the skin to the central vein in the neck, chest or groin. A central venous catheter is usually recommended if the patient needs immediate or emergency dialysis or cannot receive an arteriovenous (AV) fistula or graft.
  • Arteriovenous (AV) fistula This is a surgical connection that is formed by joining a vein and an artery in the arm and is normally done on the non-dominate arm or leg. The procedure results in increased blood flow through the vein, which will help enlarge and strengthen the vein. This is the most common hemodialysis access and may function for years and reduce infections or clots. It is the safest access for dialysis, and patients with AV fistulas have the longest life expectancy.
  • Arteriovenous (AV) graft This is a surgical procedure that works similarly to an AV fistula. An AV graft is required if the veins are blocked or damaged, or they are too small for a fistula. During the arteriovenous graft placement procedure, the vascular surgeon connects a small hollow synthetic tube to the vein, and the other end is connected to the artery.
  • Peritoneal dialysis (PD) catheter This procedure is recommended for peritoneal dialysis and involves a catheter being inserted in the lining of the abdomen, which is then connected to a bag with a dialysate solution. This procedure helps with cleaning the blood. The dialysis is recommended for people who are always on the go and can even be done at night while the patient is asleep.

How does the patient take care of the access site?

The access site is the lifeline and must be kept clean to help prevent infection. A healthy and clean access site ensures that treatment is effective, and the patient experiences minimal pain and discomfort. Caring of the site includes washing or sanitizing the hands, examining the site for any change in appearance and avoiding clothing which may rub against the site as well as sleeping positions which may irritate the site.

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"Often healing takes place in ourselves as we pray for the healing of others."
~ Michael E. DeBakey