Dialysis Access Management
The best option for dialysis access management
When your kidneys are healthy, they clean your blood and create urine, but when they fail you need treatment such as dialysis which is performed through a catheter or a fistula or graft typically in your upper arm.
Over time, your dialysis access will likely need maintenance when your nephrologists start to notice a decrease in efficiency of you dialysis, prolonged bleeding after treatment, arm swelling, or clotting of the access.
These issues are typically caused by a narrowing of your dialysis access which can be treated with a minimally invasive procedure which uses balloons and sometimes stents to stretch open the narrow areas and allow you to return to normal dialysis.
Symptoms
- Swelling or enlargement at the site of the dialysis access, such as the arteriovenous fistula (AVF) or arteriovenous graft (AVG).
- Difficulty in achieving adequate dialysis, resulting in insufficient clearance of waste products and fluid overload.
- Pain, tenderness, or discomfort at the access site, indicating potential complications.
- Signs of infection, including redness, warmth, swelling, or drainage from the access site.
Risk Factors
- Thrombosis (clotting) within the dialysis access, leading to reduced blood flow or complete occlusion, and compromising dialysis effectiveness.
- Stenosis (narrowing) of the blood vessels supplying the dialysis access, resulting in decreased blood flow during hemodialysis sessions.
- Infection at the access site, which can lead to local complications such as cellulitis, abscess formation, or systemic infections like sepsis.
- Hemorrhage or hematoma formation due to trauma, needle puncture, or vessel injury during dialysis procedures.
Diagnosis
A physician will begin the process by taking a complete medical history and thorough physical exam.
Additional tests may be used to make the diagnosis such as
- Physical examination of the access site to assess for signs of swelling, tenderness, infection, or poor blood flow.
- Doppler ultrasound to evaluate blood flow dynamics, detect abnormalities such as thrombosis or stenosis, and assess access patency.
- Fistulogram or venogram, where contrast dye is injected into the access site and X-rays are taken to visualize the anatomy of the blood vessels, identify blockages or narrowing, and guide treatment interventions.
- Blood tests to monitor dialysis adequacy, assess for changes in electrolyte levels, and detect markers of infection or inflammation.
Treatment
The procedure is performed under moderate sedation and after a short recovery period, you will be able to go home same day and resume your normal dialysis schedule
Why Choose Apex?
Our board-certified, highly experienced doctors treat each patient with individual care, attention, and comprehensive follow-up care to ensure complete rehabilitation.
