Hemodialysis Access Salvage

WHAT IS DIALYSIS AND WHAT ARE DIALYSIS ACCESS SITES?

Dialysis is a process used to treat patients whose kidneys are not working properly. It involves a special machine and tubing that removes blood from the body, cleanses it of waste and extra fluid and then returns it back to the body. Dialysis access is usually done by creating a radio cephalic fistula (above the wrist) or a brachiocephalic fistula (at the level of elbow).

WHAT ARE THE ISSUES WITH DIALYSIS ACCESS SITES?

Dialysis and Access Interventions are minimally invasive procedures performed to improve blood flow in the fistula and grafts placed in the blood vessels of dialysis patients.

Problems at dialysis access sites

  • Narrowing Of Dialysis Veins/Central veins.
  • Thrombosis of dialysis fistulas or grafts.

WHAT ARE THE INTERVENTIONS FOR DIALYSIS ACCESS SITE ISSUES/ COMPLICATIONS?

DIALYSIS ACCESS COMPLICATION SYMPTOMS TREATMENT
Narrowing of the dialysis veins (outflow) Arm, hand, face and one side of chest swelling Decreased flow in the fistula Angioplasty for the veins/ Stenting.
Narrowing of the fistula site/ arteries (inflow) Decreased flow in the fistula Angioplasty of the arteries/anastomotic site.
Acute thrombosis (clot formation) in fistula Sudden non-functioning of the fistula Thrombolysis/ thrombectomy
Immature/ non-functional fistula Patient in need of maintenance hemodialysis Angioplasty for the artery/veins

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