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Dialysis Access Surgery in Dhakuria

Dialysis Access

Dialysis Access in Dhakuria

Dialysis is a crucial treatment for individuals with acute or chronic kidney failure, serving as a life-saving measure when the kidneys are no longer able to function properly. There are two main types of Dialysis: Haemodialysis and Peritoneal Dialysis. In Haemodialysis, a dialyser machine filters the patient’s blood outside the body. In contrast, in Peritoneal Dialysis, the blood is filtered inside the body using the lining of the abdomen.

To facilitate Dialysis, a surgical procedure is performed to create access to the blood vessels or abdominal cavity. This typically involves creating a vascular access point in the arm for Haemodialysis. For Peritoneal Dialysis, a small incision is made in the abdomen to insert a catheter. It is essential to perform Dialysis Access surgery well before starting Dialysis treatment, as this allows the access site to mature, reducing the need for temporary catheters and ensuring more effective dialysis sessions.

FAQ's

When the kidneys fail, Dialysis—either Haemodialysis or Peritoneal Dialysis—replaces kidney function and can save lives. Dialysis requires a connection between the patient's bloodstream and the dialysis machine for treatment to take place. In order to introduce an abdominal catheter for Peritoneal Dialysis or a needle for Haemodialysis, a vascular opening is created during Dialysis Access surgery.

Dialysis access can be established in a few different ways. Together, your surgeon and nephrologist will determine which kind of access will provide you with the greatest long-term dialysis.

Nephrologists, interventional radiologists, and surgeons can all execute the invasive (surgical) process of setting up Dialysis Access. Excellent patient care, service, and long-term outcomes are all made possible by teamwork. Prominent nephrologists, transplant surgeons, and interventional radiologists work at the Dialysis Access Centre. Social workers, a coordinator for Dialysis Access, and nurses also make up the team.

Two long-term vascular access options for Haemodialysis are Arteriovenous Fistulas (AV Fistulas) and Arteriovenous Grafts (AV Grafts). The Venous Catheter is a third kind of vascular access that is often used temporarily.

An Arteriovenous Fistula (AV Fistula) is a surgical connection made between an artery and a vein, typically in the arm. This procedure is commonly performed for patients who require long-term Haemodialysis due to kidney failure. By connecting an artery directly to a vein, the blood flow through the vein increases, causing it to grow larger and stronger. This makes the vein easier to access for dialysis and can handle the repeated needle insertions required for the treatment.

AV fistulas are preferred for Haemodialysis because they provide a reliable and durable access point with a lower risk of infection and clotting compared to other types of access. They typically take a few weeks to a few months to mature before they can be used for Dialysis.

Advantages of an AV fistulas include the following:

  • Allows for optimal blood flow during Dialysis

  • Endures longer than alternative means of access

  • AV fistulas are less likely to become infected compared to other forms of dialysis access.

  • AV fistulas have a lower tendency to clot, which helps maintain their functionality over many years.

Risks may include:

  • Bleeding
  • Infection
  • Tingling sensation in fingers
  • Swelling in arm

When a patient's veins aren't suitable for an AV fistula, an Arteriovenous Graft (AV Graft) can be used to create dialysis access. In this procedure, a synthetic tube, often made of PTFE, is surgically placed under the skin to connect an artery to a vein, typically in the forearm or upper arm. The graft provides a reliable access point for Dialysis and is an alternative when the veins are not strong enough for an AV fistula.

An AV graft is surgically created by making an incision at the intended location, usually in the forearm or upper arm. The graft is connected to an artery at one end and tunnelled under the skin to connect to a vein at the other end, forming a continuous pathway for blood flow. The graft allows for easy access during Dialysis. Unlike AV fistulas, which require time to mature, AV grafts can typically be used about two weeks after surgery, once the area has healed sufficiently.

Benefits include the following:

  • When an Arteriovenous Fistula is not the best choice, this might be employed

  • Effective for accessing dialysis

  • Can be used for a duration of two to three years

Complications may include the following:

  • Risk of infection

  • Clotting

  • Narrowing of the blood vessels at the graft site

  • Weakening of the vessel wall around the graft can lead to the formation of an aneurysm, which could rupture if not treated

  • Steal syndrome (reduced blood flow to the hand, causing pain or weakness)

To protect your access area:

  • Keep the catheter insertion site clean with a sponge and cleaning solution.

  • Wash your hands before touching your catheter or its insertion site.

  • Avoid carrying bags or heavy objects across the access area.

  • Refrain from sleeping or resting in the access area.

  • Do not wear tight clothing or jewellery around the access area.

  • Avoid scratching or scraping the access area.

An AV fistula typically takes several weeks to months to mature, while an AV graft is usually ready for use in about two weeks.

Generally, dialysis access is dedicated to Dialysis treatments to ensure optimal function and reduce the risk of complications.

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