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    1. About Kidney Disease
      1. OVERVIEW
      2. Understanding Chronic Kidney Disease
      3. Kidney Disease Stages
      4. What Is a Nephrologist?
      5. What to Expect with CKD
      6. Kidney Disease Management
      7. Understanding Acute Kidney Injury
      8. How Kidneys Work
      9. Take a FREE CLASS on Kidney Disease
    2. Treatments
      1. OVERVIEW
      2. Dialysis Basics
      3. Benefits of Home Dialysis
      4. Home Peritoneal Dialysis
      5. Home Hemodialysis
      6. Sign up to Talk to a Home Dialysis Expert
      7. In-Center Hemodialysis
      8. Transplant
      9. Insurance & Managing Costs
      10. Choosing Not to Treat
    3. Life On Dialysis
      1. OVERVIEW
      2. Your Emotional Health While on Dialysis
      3. Staying Engaged
      4. Staying Healthy
      5. Dialysis Travel Services and Information
      6. Tips for Loved Ones
      7. PatientHub
    4. Recipes & Nutrition
      1. OVERVIEW
      2. Recipes
      3. Managing Your Diet
      4. Fluid Management on Dialysis
      5. Dialysis Diet Planning
      6. Cookbooks
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    Find a Dialysis Center

    Find a Dialysis Center

    Find a Dialysis Center
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      Need help? Call 1-888-373-1470

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      1. About Kidney Disease
        1. Understanding Chronic Kidney Disease
          1. Symptoms
          2. Risk Factors
          3. Causes
          4. Diagnosis and Testing
          5. GFR Calculator
        2. Kidney Disease Stages
          1. Stage 1
          2. Stage 2
          3. Stage 3
          4. Stage 4
          5. Stage 5
        3. What Is a Nephrologist?
        4. What to Expect with CKD
        5. Kidney Disease Management
          1. Kidney Diet Basics
          2. CKD Medications
          3. Your Kidney Care Team
          4. Diabetes
          5. High Blood Pressure
        6. Understanding Acute Kidney Injury
          1. Acute Kidney Injury Treatment and Recovery
        7. How Kidneys Work
        8. Take a FREE CLASS on Kidney Disease
      2. Treatments
        1. Dialysis Basics
          1. How Does a Hemodialysis Machine Work
          2. Starting Dialysis
          3. Types of Dialysis Access
          4. Your Care Plan
          5. Dialysis Medications
          6. Monitoring Your Lab Results
        2. Benefits of Home Dialysis
        3. Home Peritoneal Dialysis
          1. What to Expect
          2. Getting Prepared
          3. PD Access
          4. PD Training
          5. PD Monitoring
          6. Your Care Team
        4. Home Hemodialysis
          1. What to Expect
          2. Getting Prepared
          3. HD Training
          4. HD Monitoring
          5. Your Care Team
        5. Sign up to Talk to a Home Dialysis Expert
        6. In-Center Hemodialysis
          1. In-Center Treatment Options
          2. What to Expect
          3. Types of Vascular Access for Hemodialysis
          4. Your Care Team
          5. How to Choose a Center
        7. Transplant
          1. Finding a Kidney Donor
          2. Considering Kidney Donation
        8. Insurance & Managing Costs
          1. Understanding Medicare Coverage
          2. Understanding Medicare Advantage
          3. Understanding Employer Plans
        9. Choosing Not to Treat
      3. Life On Dialysis
        1. Your Emotional Health While on Dialysis
          1. Managing Your Emotions
          2. Talking About Dialysis
          3. Intimacy
          4. Body Image and Dialysis
          5. Building Your Dialysis Support Network
        2. Staying Engaged
          1. Tips for Working While on Dialysis
          2. In-Center Activities
          3. Hobbies
        3. Staying Healthy
          1. Managing Your Time on Dialysis
          2. Dialysis & Exercise
          3. Weight Management
          4. Avoiding Infection
          5. Managing Multiple Conditions
          6. Fighting the Flu
        4. Dialysis Travel Services and Information
        5. Tips for Loved Ones
          1. In-Center Hemodialysis
          2. At-Home Hemodialysis
          3. At-Home Peritoneal Dialysis
        6. PatientHub
      4. Recipes & Nutrition
        1. Recipes
        2. Managing Your Diet
          1. Eating Well on a CKD Diet
          2. Eating Well on a Dialysis Diet
          3. Salt and Kidney Disease
          4. Potassium and Kidney Disease
          5. Phosphorus and Kidney Disease
          6. Talking With Your Dietitian
        3. Fluid Management on Dialysis
        4. Dialysis Diet Planning
          1. Kidney-Friendly Shopping
          2. Eating Out
          3. Holiday Diet Tips
          4. A Chef’s Advice | Chef Aaron McCargo on Kidney Friendly Meals
        5. Cookbooks
      5. Thrive Central
        1. CKD
        2. Dialysis
        3. Diet & Nutrition
        4. Stories
        5. Wellness
        6. See All
      Dialysis Basics
      Dialysis Basics
      OVERVIEW How Does a Hemodialysis Machine Work Starting Dialysis Types of Dialysis Access Your Care Plan Dialysis Medications Monitoring Your Lab Results
      access_hero_image1238x470

      Choosing Your Best
      Dialysis Access

      Share:
      1. Home
      2. Treatments
      3. Dialysis Basics
      4. Types of Dialysis Access
      When facing dialysis, there are different types of dialysis access to consider. Peritoneal dialysis (PD) uses only one type of access—a peritoneal dialysis catheter. Hemodialysis (HD) uses an arteriovenous (AV) fistula or graft—or, if medically necessary, a hemodialysis catheter. Ideally, you want the access type that gives you the best quality of dialysis treatment and the lowest risk of infection. Talk to your doctor to determine which type of access is right for you.
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      Types of dialysis access


      FOR PERITONEAL DIALYSIS ACCESS

      Benefits of Home Dialysis

      Peritoneal dialysis catheter

      A PD catheter is a flexible tube placed in your abdomen—with a small piece of tubing left outside of the body.

      Healing time after surgery: A few days to 2 weeks, depending on the urgency to start treatment. A PD catheter can also be placed in advance for a quick start when ready.

      Key considerations

      • A PD catheter is the only access type for peritoneal dialysis.
      • It requires no needles during dialysis.
      • You must have a clean treatment environment to avoid infection.
      Learn more about peritoneal dialysis catheter

      FOR HEMODIALYSIS ACCESS

      Arteriovenous fistula

      Arteriovenous (AV) fistula

      An AV fistula is an access site formed by the joining of a vein and an artery in your arm.

      Healing time after surgery: 6-8 weeks to mature

      Key considerations

      • An AV fistula is the best choice for hemodialysis access if you're eligible.
      • It's the most natural access site since it's formed from your own blood vessels.
      • A fistula has the lowest chance of infection and clotting.
      Graft

      Graft

      A graft is an access site formed by a piece of soft tubing that connects a vein and artery in your arm.

      Healing time after surgery: 2-3 weeks

      Key considerations

      • A graft is a great alternative if your veins are too small or weak for a fistula.
      • It offers better blood flow and has a lower risk of infection than an HD catheter.
      • A graft may be replaceable with a fistula if veins get stronger or bigger after being on dialysis.
      Hermodialysis catheter

      Hemodialysis catheter

      An HD catheter is a tube placed in your neck, chest or groin.

      Healing time after surgery: Ready for immediate use after placement—not recommended unless medically necessary

      Key considerations

      • A hemodialysis catheter is often used temporarily until a permanent graft or fistula is ready for use.
      • It has a higher risk of infection and clotting due to the catheter tip's location being near the heart.
      • A hemodialysis catheter must be kept dry, which can limit bathing options.
      Learn more about hemodialysis accesses

      tips for avoiding a dialysis access infection

      Caring for your access is key

      Your access is your lifeline, so you'll need to keep it clean—avoiding infection is a top priority. With any type of dialysis access, a healthy access site can help ensure that your treatment is effective and you experience minimal pain and discomfort so you can feel your best.

      The basics of caring for your access site:

      • Practice good hygiene—clean or sanitize your hands and wear a mask for at-home treatment.
      • Check for infection—inspect your access site for changes in appearance.
      • Protect your site—avoid clothing that rubs or sleeping positions that irritate your access.
      • Talk to your nurse—if there's an issue or a question, act fast to avoid complications.
      Learn more about peritoneal dialysis catheter care
      Learn more about hemodialysis access care

      EXPLORE TREATMENT OPTIONS

      There are several treatment options when kidneys fail during ESRD. Discuss all the choices with your doctor to determine what's right for you.

      LEARN MORE

      Switching from in-center dialysis to home dialysis

      Making sure you have the best access type for you

      If you're going to start hemodialysis, an AV fistula is the best access type if you have adequate vein strength and size. A graft is also a great choice if you're unable to get a fistula.

      Vein mapping is an important first step.

      Getting a painless, noninvasive vein-mapping test helps your doctor assess the condition of your veins and determine which type of access will work best for you. Ask your doctor about the test if you haven't had one already.

      Switching access types may be an option.

      If you currently have a hemodialysis catheter and you're medically able to have another type of access, talk to your doctor right away about switching to a preferable option.

      If you currently have a graft, your vein strength and size may increase once you're on dialysis—making a fistula a possibility.

      Ask your doctor about vein mapping and learn about your access choices.

      PLANNING YOUR ACCESS SURGERY

      Once you and your doctor have decided on an access type, you’ll want to schedule your surgery. Azura Vascular Care, an affiliate of Fresenius Kidney Care, offers minimally invasive, outpatient dialysis access surgery.
      Find a location near you
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