Vascular access

Vascular access - your lifeline

Illustration of a fistula — arterial-venous fistula

Before you start haemodialysis you need a vascular access. This is the site on your body where blood is removed and returned during dialysis. To have a sufficient amount of blood cleansed during haemodialysis the vascular access should allow high volumes of blood flow.

The most common permanent access for a patient undergoing chronic haemodialysis is a native arterial-venous fistula (AVF).

A fistula is formed under the skin by joining a vein to an artery. This increases the amount of blood that flows through the vein and makes the vein grow stronger, making repeated needle insertions for dialysis treatment easier.

The process of the fistula becoming strong and large enough for needle insertion is called maturing. In general, this takes four to six weeks.

An alternative method to the fistula is called a graft. A graft is created by connecting an artery and a vein with synthetic material. Following surgery, it may take about three to four weeks before the graft can be used for dialysis.

Both access placements are done by a doctor in an operating theatre. Having good vascular access is the basis for high quality haemodialysis treatment and subsequently a major contributor to your well-being – that’s why it is very often called “your life line”!

You can lengthen the life of your AVF by taking care of your life line. This is done by following hygiene guidance and regularly monitoring your vascular access (e.g. by listening to the sound of the blood stream) and using surveillance programmes for further assessment of the vascular access).