VASCULAR ACCESS FOR HEMODIALYSIS

Vascular access is a critical component of hemodialysis, providing a way to remove and return blood to the body during the dialysis process. The type of access chosen affects the success and safety of the treatment.

Types of Vascular Access

  1. Arteriovenous (AV) Fistula
    • Description: A surgical connection between an artery and a vein, usually in the forearm or upper arm.
    • Advantages:
      • Long lifespan.
      • Lower risk of infection and clotting.
      • Best for long-term dialysis.
    • Disadvantages:
      • Requires 6–12 weeks or more to mature before use.
  2. Arteriovenous (AV) Graft
    • Description: A synthetic tube connects an artery to a vein, used when veins are unsuitable for a fistula.
    • Advantages:
      • Shorter maturation time (2–3 weeks).
      • Suitable for patients with small or weak veins.
    • Disadvantages:
      • Higher risk of infection and clotting than a fistula.
  3. Central Venous Catheter (CVC)
    • Description: A flexible tube inserted into a large vein in the neck, chest, or groin.
    • Advantages:
      • Can be used immediately.
      • Useful for temporary or emergency dialysis.
    • Disadvantages:
      • High risk of infection and clotting.
      • Not ideal for long-term use.

Choosing the Right Access

The selection of vascular access depends on several factors:

  • Health of the Patient’s Veins: Determines suitability for fistula or graft.
  • Duration of Dialysis: AV fistula is preferred for long-term use.
  • Urgency of Dialysis: CVC is used for immediate access.
  • Patient’s Overall Health: Comorbidities like diabetes or vascular diseases may influence the decision.

Care and Maintenance of Vascular Access

  1. Hygiene:
    • Keep the access site clean and dry.
    • Avoid wearing tight clothing or jewelry over the access site.
  2. Monitor for Complications:
    • Look for redness, swelling, or pain (signs of infection).
    • Check for a “thrill” (vibration) in the fistula or graft daily.
    • Report bleeding, clotting, or changes in blood flow immediately.
  3. Protect the Access:
    • Avoid blood pressure measurements or needle sticks on the access arm.
    • Do not carry heavy objects or sleep on the access arm.
  4. Routine Check-ups:
    • Regularly assess the functionality and health of the access.

Potential Complications

  • Infections: More common with CVCs and grafts.
  • Clotting: Can occur in any type of access, reducing effectiveness.
  • Steal Syndrome: Reduced blood flow to the hand, causing pain or numbness (more common in AV fistulas).

Angiocare hospital, Hyderabad well trained to take on vascular access procedure wherein, a patient is completely depended on hemodialysis lifeline, because it makes life-saving hemodialysis treatments possible. Dr. Puneeth Joopalli expert in using hemodialysis treatment procedure for kidney failure patients using a world class machine to send the patient’s blood through a filter, called a dialyzer, outside the body in complete aseptic condition. The patient diagnosed with kidney failure and comes for hemodialysis to angiocare hospital, goes through quickly surgical procedure which in, using g rafting and surgery identify a vein used to remove and return blood during hemodialysis. The blood passes through a needle restrained, with minimum flow rate which can programmed according to real time blood of human being.The blood then travels through a tube that takes it to the dialyzer. The dialyzer used in angiocare, Hyderabad is of higher quality containing thin fibers inside that can completely separate out wastes and extra fluid. The machine in Angiocare hospital in Hyderabad returns the filtered pure blood to the body through a different outlet tube. The vascular access setup is designed in such a way that let large amounts of blood flow continuously during hemodialysis treatments.

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Angiocare Hospital, located in Tarnaka and Kukatpally, is renowned as one of the best hospitals in Hyderabad, offering comprehensive medical services in urology, orthopedics, vascular care, dental care, laparoscopic surgery, gastrointestinal care, gynecology, and general medicine.

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