For people with kidney failure, there can be a long wait for a suitable kidney transplant. In the interim, you will need to have dialysis to clean and filter the blood, replicating the function that the kidneys usually carry out. The dialysis requires access to a large vein in order to access the blood supply.
Assessment
For people who have a sudden collapse in blood function, there may be an initial access point placed in the neck in hospital. For others who have declining kidney function, there may be a period where they have assessments of kidney function and some interim management techniques such as a low electrolyte diet to minimise load on the kidney. The vascular surgeon will take blood samples during this time and plan the best time for surgery to create an access point.
The surgeon will assess the overall health of the patient and examine the blood vessels in the body to find a suitable access point. The first preference is to use an existing vein and artery in either the leg or arm to create an easy to access dialysis point. The surgeon will examine the size and stability of the vessels in these areas to assess the best place to create the access point.
Surgery
The surgeon will then operate to create the point. If on further examination the vein appears weak, they may opt to use a graft to create a stronger access point. As this area will be used for several times a week, potentially for years until a transplant is available, the surgeon wants to ensure that the point is robust. This surgery can be performed under local anaesthetic, although some patients prefer to be under a general anaesthetic for comfort. The surgeon opens the area and creates an incision between vein and artery so that the patient's blood can be efficiently circulated during dialysis.
Post surgery
Immediately via surgery, there may be some swelling and discomfort, which can largely be managed with ice packs and light pain relief. The surgeon will examine the site for signs of infection and indicate when dialysis can commence.
During dialysis
During each session, the dialysis nurse will examine the port for signs that the blood is flowing smoothly and there is no blockage or infection. If there is a collapse of a vessel they will refer the patient for a follow-up with the vascular surgeon who can either repeat the procedure in another limb or opt for another procedure such as a graft.
If you have any questions about your surgery to create a dialysis access point, you should ask your vascular surgeon for more information.
Share24 February 2017
Hello there! Welcome to my blog. I would like to start by telling you a story about something that happened to me many years ago. I was working in Sydney at the time as an investment banker. The hours were long and I would party every weekend to de-stress. I put on a lot of weight and began to have problems sleeping. I didn't pay much attention to the problems, as I thought I was invincible. However, one day I collapsed at work. At the hospital the doctors saved my life. Since then, I have become very interested in health and medical matters.