Vascular Access for Dialysis

Dialysis is a medical treatment that involves passing the blood through a specially designed filtering system that removes toxins. This function is normally performed by the kidneys, so it is a life-saving treatment in the event of kidney failure. Dialysis is usually done through a blood vessel in the arm, or by an alternative method of filtration using special exchange fluids passed into the abdomen known as peritoneal dialysis. To make these treatments possible small operations are needed to put special access points in place within the body for the dialysis. These procedures can be performed using minimally-invasive techniques and include:

  • Arteriovenous fistula – this is an operation that connects an artery and a vein, usually in the arm, which can be used to as an access point for connecting the individual to dialysis
  • Fistuloplasty – sometimes the arteriovenous fistula can become narrowed or blocked. Fistuloplasty aims to open up the fistula from inside the blood vessel. This is done using a small balloon, which is passed into the fistula via another blood vessel using a long, thin wire. The balloon is then inflated inside the vessel to widen it. This can also be done surgically.
  • Peritoneal dialysis catheters – peritoneal dialysis is dialysis that is done through the abdomen. For this, a thin tube known as a ‘catheter’ is surgically placed into the abdomen to allow the exchange of toxins from the body into clean dialysis fluid
  • Vascular and other minimally-invasive surgeries
  • Renal surgery can extend to operations that are performed on organs and structures related to the kidneys, such as surrounding blood vessels. Examples include
  • Surgery for aneurysms of the renal artery – swellings in the blood vessels that supply your kidneys (the renal arteries) can stop the kidneys working well. These swellings are known as ‘aneurysms’ and can be fixed surgically
  • Surgery for ‘middle aortic syndrome’ – ‘middle aortic syndrome’ is a rare condition usually affecting children and young adults, where the large blood vessel in the abdomen (known as the ‘aorta’) becomes narrowed. This can also affect the renal arteries (blood vessels supplying the kidneys), which limits the kidneys’ blood supply. An operation is needed to widen or replace these vessels and restore blood flow to prevent the kidneys from failing

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