Types of vascular access routes:

  • Fistula
  • Graft (artificial vein)
  • Permanent and temporary catheter

Fistula:
The best access method is for hemodialysis. This method is preferred over other methods due to its longer life and the absence of problems such as infection and clotting. The fistula should be placed several months before dialysis begins so that it has enough time to be used.

Graft (artificial vein):
It is the second choice for vascular access and is suitable for patients who cannot have a fistula due to inadequate vascularity. The graft should be placed at least 2 weeks before use.

Permanent and temporary catheter:
It is the simplest method for performing dialysis in emergencies. It can be implanted in the neck, chest, or thigh at the discretion of the surgeon and can be used immediately.

Fistula and graft care:

  • Do not take blood pressure from the arm with a fistula or graft.
  • Blood collection and injections from hands with fistulas and grafts are prohibited.
  • Avoid wearing watches and bracelets on the hand with a fistula or graft.
  • Avoid lifting objects and heavy exercise with the hand that has a fistula and graft.
  • Do not shave the area with fistula or graft.
  • Avoid sleeping on the hand with a fistula or graft.
  • If there is bleeding from the fistula or graft site, apply pressure to the area with cotton.
  • If you notice that the fistula or graft is not vibrating or making any sound, or if it has changed, inform the dialysis staff.

Catheter care:

  • Avoid pulling catheters.
  • Wear a waterproof dressing when bathing and dry the catheter site and re-dress immediately after bathing.
  • Notify your nurse if redness, itching, or pain occurs.
  • If the stitches come loose, go back for re-stitching.
  • If the catheter is removed due to negligence, avoid returning it to its previous location.

Important tips for dialysis patients:

  • Regular visits for hemodialysis
  • Carrying a card of medications
  • Avoid eating food during dialysis.
  • Inform the nurse if you are taking insulin or blood pressure medications.
  • Inform the nurse if you have any bleeding (nosebleeds, stomach bleeding, etc.)
  • If you have any problems such as diarrhea, vomiting, etc., inform your nurse.
  • Avoid taking medications without a doctor’s prescription.