Hemodialysis Access Maintenance Q & A
In the late stages of chronic kidney disease, regular hemodialysis performs the job of the damaged kidneys. It is imperative that the access site, called a fistula or graft, is not clotted, so dialysis can be performed as prescribed by your Nephrologist. When the site becomes clotted, your Nephrologist will refer you to a specialist who is trained to quickly restore access to the site, so your treatments can continue as soon as possible.
What are warning signs that my fistula or graft may be clotted?
- Difficulty placing needles for dialysis
- Alarms sounding during dialysis
- Inadequate dialysis
- Cold or painful hand
- Swelling in arm or hand during dialysis
What tests are performed?
The doctor may perform a fistulagram to check blood flow through the fistula and pressure in the vein. A fistulagram is a minimally invasive procedure that allows him to see inside the access site using image-guidance/flouroscopy.
How are clots and blockages treated?
If he discovers a clot, the doctor may perform thrombectomy to remove blood clots and/or venous angioplasty and stenting to ensure the blood vessels stays open for dialysis access.