Dialysis Access

Abstract

The development and maintenance of a functional hemodialysis access is an important component of the care of patients with end-stage renal disease (ESRD), acute renal failure, or other conditions requiring dialysis. Interventional radiologists (IR) serve an important role in the placement of tunneled venous catheters and in the care and maintenance of AVF and AVG dialysis access points. The type of access point used for hemodialysis will differ based on the clinical scenario and the acuity of the presentation, as outlined below:Acute renal failure: Access is achieved by double-lumen tunneled venous dialysis catheters, which are not used for long-term dialysis therapy due to the risks of occlusion, infection, and venous stenosis. Long-term dialysis: Access is achieved by arteriovenous fistula (AVF) formation or arteriovenous graft (AVG) placement.