Dialysis Access

Dialysis Access Service

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The Jennie Stuart Health's dialysis service is a multi-center practice that specializes in all aspects of managing access for dialysis patients. We focus on the needs of dialysis patients and provide up to date, innovative, and emergent access treatments for dialysis patients throughout Western Kentucky and Northern Middle Tennessee. We understand how difficult it can be to make an appointment when patients have complications with their access. Therefore, we work on a same day, next day service model so all issues are responded to in an expedient manner.

Services provided include:

• Ultrasound for new AV access planning or evaluating established AV access
• New dialysis access placement (AVF or AVG) including basilic vein transposition and Hybrid AV access placements for difficult venous anatomy such as HeRO grafts and suturless venous anastamosis
• Laparoscopic peritoneal dialysis catheter placement, revision or removal
• AV access revision or declot
• Hemodialysis catheter placement or exchange
• Angiogram (fistulogram)
• Balloon angioplasty or stent placement for AV access narrowing
• Management of aneurysms within AV access
• Removal of infected AV grafts

Your Dialysis Access Team

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Our dialysis access service’s ability to provide prompt, state-of-the-art care is a direct result of the dedication from our dialysis access team. We work very closely with nephrologists and other medical providers in the community to coordinate care prior to and following dialysis access surgery and other interventions.

What is Dialysis Access?

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Dialysis access allows a patient to be connected to a dialysis machine. During dialysis, approximately 400ml of blood per minute can be transferred from the patient to the machine which adjust fluids and electrolytes, removes toxins and returns "purified blood" back to the body. Dialysis is necessary to clean the blood when the kidneys have failed.

The three most common types of dialysis access

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Arteriovenous Fistula

An arteriovenous (AV) fistula is created when an artery is connected directly to a vein, often in the forearm. This allows blood to flow into the vein and causes the vein to grow larger and stronger, making repeated needle insertions for dialysis possible. Fistulas have proven to be beneficial for long term dialysis because they can last longer and are less likely to become infected or clotted.

Arteriovenous Graft

If you have small veins that won’t develop properly into a fistula, a plastic tube or graft can be implanted under the skin to connect between the artery and vein. The graft becomes an artificial vessel that can be used repeatedly for needle placement during dialysis.

Catheter

If your kidney disease has progressed quickly, you may need to have a venous catheter as a temporary access. A catheter is a tube that is inserted into a vein in your neck, chest or leg. A catheter has two chambers that allow a two-way flow of blood so needle insertion is not needed. Catheters are not ideal for permanent access, but they can be used temporarily while a permanent access develops.