Dialysis Access Complications

What is a Dialysis Access Site?

Patients with dialysis have poorly functioning kidneys, so their blood can no longer be filtered normally. Therefore, these patients rely on an external machine to perform this function. In order for this to occur, the machine must connect to the bloodstream, at the dialysis access site. This connection permits the machine to filter salts, proteins and other chemicals.

There are three types of access sites: a fistula, a graft, and a catheter. Fistulas are the most common and long lasting of the options, but require a surgical connection between an adjacent vein and artery, and take several months to mature before use can begin. Grafts use an artificial tube to connect an artery to a vein, but can be functional within two weeks. Catheters are typically used as a temporary access–for example, an access for someone waiting for a fistula to mature, but needs dialysis immediately. Each type of access comes with its pros and cons, and patients should discuss with their doctors which is right for them.

Dialysis Access Site Complications

Unfortunately, even patients who take the best care of their access sites may experience some form of complication. Here are some of the most common access complications:

  • Clotting – when this occurs, the access becomes completely blocked and cannot be used without an additional intervention.
  • Blockage of the access – typically noticed by decreased flow in the access, prolonged bleeding after dialysis, arm swelling, or incomplete dialysis.
  • Any bleeding longer than 20 minutes after dialysis is a reason for alarm.
  • Poor circulation in the access arm – numbness, tingling or frankly cold and painful hand. This requires immediate attention from your MD.
  • Infection – this can occur at any time during the life of your access and may be noted by redness, warmth or drainage from the access site. This may require antibiotics or surgical correction.

Treatment Options

Depending on the complications that arise, there are many forms of treatment options. Fortunately, most complications can be treated in a minimally invasive fashion without open surgery. Click here to learn about what Palm Vascular can do for dialysis access management.