Dialysis is a life-saving treatment for people with end-stage kidney disease who can't filter waste from their blood.
UPMC is a leading health system in the U.S. and the only one that offers a dedicated Dialysis Access Center. We specialize in creating access points so your blood can flow in and out of your body during dialysis treatment.
Dialysis is a treatment for people with end-stage kidney disease.
If your kidneys can't filter waste from your blood, fluid and toxins can build up in your body. This can lead to serious health problems and, after enough time, death.
Dialysis is a process that uses a machine to take over for your kidneys. Your blood travels through the dialysis machine to control blood pressure and remove waste, salt, and excess water.
Dialysis access provides a direct pathway to your bloodstream.
You'll have minor surgery to create the access point in your body. This lets your blood flow through soft tubes and a filter to the dialysis machine for cleaning.
At the UPMC Dialysis Access Center, we're experts in access techniques.
After looking at your health history and treatment plan, your surgeon will suggest which type is right for you:
Hemodialysis is the most common form of dialysis in the U.S.
It pumps blood out of your body, filters it through a machine, and returns it to your body.
Types of dialysis access techniques include:
What: Doctors connect an artery and a vein, often in your arm.
Pros:
Cons:
What: Doctors use a soft, man-made tube to connect an artery and a vein.
Pros:
Cons:
What: Doctors place a soft tube in a large vein in your neck, chest, or leg.
Pros:
Cons:
PD clean the blood while resting at night. It occurs through a small tube in the stomach lining for fluid exchange.
Pros:
Cons:
With hemodialysis, you must go to a dialysis center for treatment.
You can do PD treatments at home or any clean setting.
After training at a dialysis center, you'll do your PD treatments at home on your own schedule. You can often do PD at night, while you sleep.
Before your surgery, you'll have a thorough physical exam.
You'll also talk with your surgeon about what's best for you: fistula, graft, or catheter placement.
In most cases, surgeons will place the fistula or graft in your non-dominant arm.
Sometimes, they may place it in your dominant arm. In rare cases, they'll place it in your thigh.
On the day of your AV fistula or graft, you may receive:
Most often, your surgeon will place the catheter in your neck or chest. They may also place it in your leg.
On the day of your surgery, you'll receive:
Your surgeon will place the catheter in your abdomen 10 to 14 days before you start dialysis.
Placement occurs during a short, minimally invasive outpatient surgery.
Your vascular surgeon will:
If you're getting a:
After creating the fistula or placing the graft, your surgeon will close your incision with sutures your body will absorb.
Your vascular surgeon will:
The term for the PD process is an exchange.
You'll likely complete 4 to 6 exchanges each day using these steps:
There are different types of PD.
They are continuous:
No matter which type of dialysis access your surgeon does, it's vital to keep the access point healthy and clean. This will help you avoid problems, such as missed dialysis treatments and hospital stays.
Even if you keep the access point clean, you can get clots or an infection. If this happens, your surgeon needs to reopen the site right away.
Before you leave, your surgeon will tell you:
If you have an AV fistula or graft, your vein will slowly get larger.
You should feel a vibration when you place your hand over the access point.
Your arm or leg may also feel cool at times because the placement redirected some of your blood supply.
You should start dialysis treatment using a:
People on dialysis may need to take nutritional supplements to replace those they lack from having to avoid high-potassium foods.
Peritoneal dialysis removes protein. So, you may need to eat higher amounts of protein.
You may also need fluid restrictions. Because the kidneys can't filter fluids, they're prone to building up excess fluid in the body. Your doctor may advise you to limit fluids to a certain amount each day.
Like all health treatments, dialysis access surgery can have some risks, such as bleeding and infection.
Rarely, people suffer a major lack of blood flow to the limb with the fistula or graft. This can cause pain and dysfunction in the arm or leg.
Contact your surgeon right away if you have:
The most common complications from peritoneal dialysis include infection:
Less often, problems related to the catheter may arise. But you can manage and prevent most issues.
The staff at our dedicated Dialysis Access Center can:
We offer a full range of services, such as:
To contact our Pittsburgh and southwest Pa.offices:
To contact our Harrisburg offices, please call 717-920-4330.
We have two UPMC Dialysis Access Centers in Harrisburg.
Brady Building
205 South Front St., 8th Floor
Harrisburg, PA 17104
Phone: 717-920-4330
UPMC Outpatient Center
Phone: 717-920-4330
