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Hemodialysis access is the route used to move blood between your body and a dialysis machine. It may be an arteriovenous (AV) fistula, an AV graft, or a venous catheter. Your dialysis team checks how it's working at every session and arranges specialist assessment when a problem is suspected.
The three types of access
- AV fistula — a surgical connection between your own artery and vein, which enlarges and strengthens the vein for dialysis needles. Needs time to mature before use.
- AV graft — a soft tube placed under the skin connecting an artery and vein. Often usable sooner than a fistula.
- Venous catheter — a tube placed in a large vein. Catheters are often used temporarily, though some patients need one longer-term as part of their care plan.
More detail on the first two in our pages on AV fistulas and AV grafts.
How access is monitored
Your dialysis team checks the access at every session — the feel of the thrill (vibration), how the treatment runs, how bleeding behaves afterward. When something changes, a specialist evaluation is arranged. Imaging and procedures are used when there are clinical signs of a problem — not on a routine preventive schedule. Treating every narrowing found on a scan, before it causes any problem, isn't recommended; treating dysfunction that's affecting your dialysis is.
What an access specialist does
An interventional specialist evaluates the access when problems are suspected, uses imaging to find the cause, and treats problems such as significant narrowing or clotting — with the goal of keeping dialysis access working and treatments on schedule. The specialist works alongside your nephrologist and dialysis center rather than replacing them.
Frequently asked questions
How do I know my access is working?
A healthy fistula or graft has a steady buzz or vibration (the thrill) you can feel. Learn what yours normally feels like — and report any change to your dialysis team.
What does access care involve?
Routine care is simple: keep the skin clean, avoid pressure on the access arm, and check the thrill. Procedures come into play only when there's a problem to fix.
How often is my access checked?
At every dialysis session, as part of routine care. Specialist evaluation happens when your team notices something worth investigating.
For routine access questions and coordinated care, request a consultation or call (561) 408-0304. If your thrill has changed or dialysis can't proceed, call your dialysis or access team immediately — see our guide to dialysis access warning signs.
This article is general health information, not medical advice, and does not replace an evaluation by a clinician. If you think you are having an emergency, call 911.
Related articles
Dialysis accessAV Fistula vs. AV Graft: Choosing Dialysis Access
Compare AV fistulas and grafts — readiness for dialysis, possible complications, and the factors that guide an individualized access plan.
Dialysis accessDialysis Access Problems: Warning Signs and What to Do
Know which dialysis access changes need an immediate call, when bleeding is an emergency, and how evaluation is arranged.
Dialysis accessWhat Is an Interventional Nephrologist?
What an interventional nephrologist does, how dialysis access care is coordinated, and when a referral may help.