Learning More About the Ins and Outs of Dialysis

• 14 March 2019
• Dr. Obinna Nwobi

Kidney disease affects about 14% of all Americans. Chronic kidney disease is a progressive condition that ultimately becomes so severe your kidneys can’t function. When that happens, you need dialysis — which means you also need dialysis access. Here at Vein Health Clinics, we specialize in creating and maintaining life-saving dialysis access.

Understanding kidney disease

Your kidneys are responsible for filtering wastes and excess fluids out of your blood. In the process of filtering your blood, they regulate the amount of calcium, sodium, and potassium circulating in your bloodstream. The kidneys also produce hormones that are essential for controlling blood pressure and maintaining strong, healthy bones.

The two most common causes of kidney disease are high blood pressure and diabetes. Both conditions damage the small blood vessels in your kidneys, interfering with kidney function. You may also develop chronic kidney disease as the result of an immune system disorder, polycystic kidney disease, or overuse of toxic drugs.

Chronic kidney disease can’t be cured. Once it develops, it gradually worsens, and your kidneys lose their ability to fulfill their vital roles. As a result, toxic wastes accumulate in your blood and electrolytes become imbalanced, which interferes with heart, nerve, and muscle function.

If you lose 85-90% of your kidney function — a condition called end-stage kidney failure — you need dialysis.

How dialysis treats chronic kidney disease

Dialysis takes the place of your kidneys, filtering and cleaning your blood so that you can maintain optimal health despite kidney failure. There are two types of dialysis:

Peritoneal dialysis

During peritoneal dialysis, your blood is cleaned inside your body. We insert a catheter into your abdomen, then it’s used to slowly fill your abdomen with a fluid that pulls wastes out of your blood and into the fluid. Then the same catheter is used to drain the fluid, which eliminates the waste.

Hemodialysis

When you receive hemodialysis, tubes are inserted into blood vessels in your arm, then the tubes are connected to a machine. Your blood flows out of one tube and into the dialysis machine, which filters waste out of your blood. The filtered blood leaves the machine and returns to your body, going through the second tube and directly back into your blood vessel.

Creating and maintaining permanent dialysis access

Here at Vein Health Clinics, we specialize in creating permanent dialysis access. In addition to surgically implanting an abdominal tube for peritoneal dialysis, we also create two types of access for hemodialysis, an arteriovenous (AV) fistula, and an AV graft.

AV fistula

We create this access by surgically connecting an artery to a vein in your arm. When we join the two blood vessels together, more blood flows from the artery into the vein, which enlarges and strengthens the vein.

It takes the vein several months to heal before the AV fistula can be used for hemodialysis, but once the vein is ready, you have easy access to the hemodialysis catheters.

An AV fistula is preferred over a graft because the enlarged vein allows blood to flow in and out of the dialysis machine more quickly. The fistula is also less likely to become infected or clotted.

AV graft

An AV graft is like a fistula except we use a plastic tube to connect the artery to the vein. We may recommend this procedure if your arm veins are too small or too weak for an AV fistula. However, AV grafts tend to close more quickly, and they’re prone to infection.

Once your dialysis access is created, we provide ongoing care to ensure the fistula or graft stays healthy and clear. We regularly check blood flow through the access vessel and check the pressure in your vein. If necessary, we perform a thrombectomy to remove blood clots or we may insert a stent to ensure the vein stays open.

You won’t face dialysis alone. We’re here at Vein Health Clinics to ensure you have the access you need to receive routine hemodialysis or peritoneal dialysis. If you have questions or you need to have dialysis access created, call the office or schedule an appointment online.