Vascular access routes for hemodialysis

Autologous arteriovenous bypass, vascular grafts, and central venous catheters are common vascular access routes for hemodialysis.

The vascular access is the path that connects the blood vessels to the hemodialysis machine. Dr. Ho Tan Thong, Department of Nephrology - Dialysis, Center for Urology - Nephrology - Andrology, Tam Anh General Hospital, Ho Chi Minh City, said that this is a "vital path" for hemodialysis patients because it is responsible for removing toxins and excess substances from the blood, preventing life-threatening complications.

Depending on the health condition and dialysis situation, the doctor will prescribe the appropriate vascular access for each patient, including:

Autologous arteriovenous bypass (AVF) : This is the ideal vascular access for patients with chronic kidney failure who require long-term hemodialysis.

In this method, the vein is connected to the artery (in the arm), creating a blood circulation path from the artery to the vein back to the heart. This helps increase blood flow through the vein, improves the strength of the vein wall, makes it easier to place the dialysis needle and can be repeated many times. Autologous arteriovenous shunt is the most durable access to the dialysis blood vessel and has the lowest risk of infection and low risk of forming a blood clot.

Nurses in the Department of Nephrology - Dialysis, Tam Anh General Hospital, Ho Chi Minh City, prepare blood lines for dialysis patients. Photo: Provided by the hospital — Nurses in the Department of Nephrology - Dialysis, Tam Anh General Hospital, Ho Chi Minh City, prepare blood lines for dialysis patients. Photo: *Provided by the hospital*

Arteriovenous bypass with artificial vascular graft (AVG) : In cases where the patient's blood vessels are too small or AVF surgery has failed, the method of creating an arteriovenous bypass with an artificial vascular graft will be chosen.

The doctor inserts an artificial blood vessel under the skin of the patient's arm. One end of the tube is connected to an artery, the other end is connected to a vein. After surgery, the patient can only receive dialysis through this bridge at least two weeks later. Because the artificial bridge is implanted with foreign materials, it has a higher risk of infection and blood clots than the patient's own bridge. This graft can work for many years if the patient takes good care of it.

Central venous catheter : This method is indicated in situations where the patient has sudden kidney failure, needs emergency dialysis while the AVF or AVG is not stable enough for dialysis, or people with acute kidney injury need temporary hemodialysis.

The doctor places a catheter into a large vein in the patient's neck or thigh (this can be done under ultrasound guidance). The catheter is removed when the arteriovenous shunts are suitable for dialysis.

Regardless of which blood vessel is used for dialysis, the patient must keep clean and dry, wash hands with soap or medical alcohol before touching. Avoid great pressure or trauma to the arm with the shunt such as lifting heavy objects, sleeping on it, collisions, scratches... Absolutely do not infuse fluids, take blood, measure blood pressure; do not wear watches or bracelets on the arm with the shunt.

Doctor Tan Thong recommends that people on dialysis need to strictly follow the doctor's instructions for taking care of the dialysis bridge. If any abnormalities are detected, the patient should go to the hospital for timely treatment.

Thang Vu

Source link