Dialysis access should be in place and fully healed several weeks or even months before the first hemodialysis treatment. There are three main types of vascular access sites; two are designed for long-term use, and one is intended for short-term use.
AV fistula
Considered the best long-term dialysis access opening because it’s less prone to clotting and carries a low risk of infection, an AV fistula involves taking part of a vein from your arm or leg and grafting it onto an artery in your arm.
Also called a dialysis fistula, this approach causes the sewn-in vein to enlarge and become thicker, much like an artery. Although it can take 1-4 months to heal before it’s ready for use, an AV fistula makes needle insertion easy during treatment.
AV graft
An AV graft is a dialysis access that uses a soft tube (prosthetic graft) to join an artery and a vein in your arm. If your blood vessels aren’t strong or large enough for fistula surgery, an AV graft is the next best long-term access option.
An AV graft heals more quickly and can be ready for use in as little as 3-6 weeks. Because it involves a prosthetic, however, an AV graft is more vulnerable to infection than an AV fistula. During hemodialysis treatment, the needles are inserted directly into the graft.
Venous catheter
A central venous catheter is a soft tube that’s placed in a large vein, usually in the neck. While it can be used immediately, this type of dialysis access is intended for short-term hemodialysis because the risk of infection is relatively high.
A venous catheter is often used when kidney disease has progressed quickly, and a patient can’t wait for the placement of an AV fistula or an AV graft before starting hemodialysis.
