Common Dialysis Access Terms Every Patient Needs to Know

Common Dialysis Access Terms Every Patient Needs to Know

Are you recently coming to terms with the fact that you need dialysis? At Azura Vascular Care, we realize you will be experiencing many lifestyle changes during this time. We are here to help you learn what seems like an entirely new language.

Have you been feeling overwhelmed by the terminology used by doctors when discussing dialysis access? Understanding the associated terms can help you better communicate with your healthcare team and make informed decisions as you undergo the dialysis access process.

Let’s focus on the basic language first, and then we will progress to more advanced terms.

The Basic Terms Of Dialysis Access

To begin, it is highly important that you understand the following three terms that are related to the type of treatment you will be receiving.

A dialysis access, also known as “an access,” is every dialysis patient’s lifeline. Dialysis is a treatment for kidney failure that filters blood to remove excess fluid and waste products normally removed by your kidneys.  An access is necessary to make dialysis treatments possible.
Hemodialysis is a procedure during which a dialysis machine is used to filter wastes, salts and fluids from your blood since your kidneys are no longer able to do so. Hemodialysis requires a dialysis access to remove your blood and send it to the dialysis machine and return it to your body after it has been filtered outside of your body.
Peritoneal dialysis is a treatment that uses the lining of your abdomen (belly area), called your peritoneal membrane, and a cleaning solution (dialysate), to clean your blood. Dialysate removes waste and fluid from your blood, using your peritoneal membrane as the filter. PD is another method of treating advanced kidney failure.

Types of Access

The next group of terms you should learn is related to the type of access you have. Remember that your access allows you to undergo dialysis. Again, we’ll break down these terms to facilitate understanding.

An AV fistula (also called an arteriovenous fistula, or a dialysis fistula) is formed by joining an artery and a vein together under the skin in your arm. When the artery and vein are joined, the increased pressure in the artery causes the blood to flow into the low pressure vein. As a result, the size of the vein increases and the walls of the vein become stronger. The larger, stronger vein can then accommodate the needles required for hemodialysis.
An AV graft (also called an arteriovenous graft or graft) is formed by joining an artery and vein in your arm with a hollow synthetic tube. One end of the tube is surgically connected to an artery, and the other end is surgically connected to a vein. Blood flows from the artery and into the vein through the graft (the synthetic tube). During dialysis, the needles used for hemodialysis are inserted into the synthetic tube to transfer blood to the dialysis machine and back to the patient.
A Central Venous Catheter is a long, y-shaped, soft plastic tube that is placed in a large vein, usually in the patient’s neck. This type of access is temporary until a more permanent access can be created.
A PD catheter is used for patients receiving peritoneal dialysis (see above).

Access Assessment & Evaluation

Along with being able to communicate with your healthcare team about your dialysis treatment and access type, you’ll want to understand the language of access assessment. This includes those performed by you, as well as your healthcare team.

A swooshing sound heard within a fistula or graft. This sound is generated by the high-pressure blood flow traveling through your AV fistula or AV graft.
The vibration felt when placing your fingers along the fistula or graft. This sensation is a result of the blood flowing through the access.
A special x-ray procedure that uses contrast (x-ray dye) to evaluate stenosis, or narrowing, of your access. This involves the injection of a contrast dye through a catheter into your access to see if there is a blockage or narrowing.
A procedure performed to evaluate the size and depth of your arteries and veins to help determine which vessels are best suited to create a dialysis access.

Things to Be Aware Of

While it is ideal to avoid complications over the course of your treatment, it is necessary that you understand the nature of complications if they occur. Below are some common terms you should become familiar with:

An Aneruysm is a weak spot in the wall of a vein or artery. Find out more about aneruysms here.
Blood that collects in the tissue outside of a blood vessel caused by a puncture through the wall of a blood vessel. A hematoma looks like a large bruise.
“Pseudo” means false. Thus, a pseudoaneurysm is similar to an aneurysm, but it doesn’t involve the entire thickness of the vessel wall.
In this condition, your access “steals” blood flow from the hand of your access arm. If you have Steal Syndrome, this reduced blood flow to the hand can make your hand swell, feel cold, painful, and may appear blue.
A narrowing in the blood vessels of your access.
The formation of a blood clot (a thrombus) in your dialysis access which can block or completely obstruct blood flow.

Treating the Dysfunctional Access

Here are some terms related to the treatment of dysfunctional access problems:

An angioplasty is a procedure used to widen the narrowing (stenosis) and restore adequate blood flow through your dialysis access.
The repair of an AV access that is not functioning properly.
A small, mesh, metal tube permanently placed inside a narrowing or blockage of a blood vessel to keep it open.
The removal of a blood clot, also called a thrombus, from a graft, fistula or CVC.

Understanding the common terms related to dialysis access is important so that you’re able to better communicate with your healthcare team. Being well informed allows you to spend less time researching and more time focusing on staying healthy!

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