Patients who require hemodialysis need reliable vascular access. Access planning depends on kidney disease stage, previous access, vascular anatomy and the dialysis team's plan.
An arteriovenous fistula (AVF) is a surgical connection between an artery and vein designed for repeated hemodialysis access. It generally requires time to mature before use.
Tunneled dialysis catheters and temporary double-lumen catheters may be used in selected circumstances, including when immediate access is needed or while longer-term access is being planned.
Early referral and preservation of suitable veins can be important for patients expected to need long-term hemodialysis.
Dialysis catheters carry infection and thrombosis risks and require careful handling by the dialysis team.
Vascular access decisions should be coordinated with nephrology/dialysis teams.
Treatment decisions are individualized after appropriate clinical assessment.
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