Kidney Dialysis Access Services & Procedures

One of the major functions of kidney is to remove waste products from the blood. These waste products are then eliminated in the urine. When the kidneys do not function properly, the blood is not cleaned. This results in build-up of waste products and unwanted electrolytes in the blood. Patients may experience high blood pressure, fluid retention, drowsiness, anaemia and feeling unwell.

When more than 90% of kidney function has lost, dialysis will be needed in order to keep the body waste, electrolytes and water in balance.

Types of dialyses:

Vascular access or haemodialysis access, is a procedure performed to allow easy access to the blood for haemodialysis i.e. to clean the blood. The access allows blood to go to the machine through one of the tubes, gets cleaned in the dialyzer (a special filter), and returns to patient through the other tube.

  • Arteriovenous (AV) fistula – AV fistula should be considered the first choice for dialysis access because it generally lasts longer and has fewer problems such as narrowing, infections and clotting. The access is created by joining an artery and a vein the arm, allowing blood flows directly from an artery into a vein. The increased flow and pressure cause the veins to enlarge and widen. The enlarged veins allow adequate amount of blood flow necessary for efficient haemodialysis. The procedure is often performed as a day surgery, under local anaesthesia.

    When receiving dialysis through a fistula, two needles will be placed in the enlarged vein of the AV fistula, connected to a dialysis machine through tubing. The arterial needle will remove blood from the vein and the blood will pass through the dialysis machine for cleaning before returning to the vein via the venous needle.

  • Arteriovenous (A V) graft- an access made by using a piece of soft biocompatible synthetic tube to join an artery and vein in your arm. This option is generally reserved for patients with no suitable vein in the arm for creation of AV fistula. This is because graftsare at higher risk of infection and clotting.
  • A Dialysis catheter – a plastic tube is placed in a large vein, usually in your neck. The tip of the catheter is resting in the right heart chamber while the while the external part of the catheter consists of two tubing, one tubing is responsible for removing the blood for dialysis (cleaning) while the other allows cleaned blood to return to the body. This is generally used as a temporary access because of high risk of infection and clotting.

Peritoneal dialysis uses the inner lining (peritoneum) of abdominal cavity to filter our unwanted waste materials from the blood. The procedure involves placing a plastic tube in the abdominal cavity through abdominal wall. During peritoneal dialysis, a special sterile solution is introduced into the abdominal cavity via the catheter. The solution will circulate through the abdominal cavity, drawing wastes from the surrounding blood vessels before draining out from the body into a disposable collection bag.

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