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Vascular
Access
HomeTAKING CARE OF YOUR VASCULAR ACCESS IN HEMODIALYSIS
Your vascular access is your lifeline during dialysis. Whether you have an arteriovenous fistula or a central venous catheter, proper care is essential to ensure effective treatment and prevent complications. Here’s how to maintain and protect your vascular access.
Understanding Your Vascular Access
There are two main types of vascular access for hemodialysis:
1/ Arteriovenous Fistula (AVF) : The Preferred Option
An arteriovenous fistula is the recommended vascular access for hemodialysis because it provides the best long-term durability and the lowest risk of infection. It is surgically created by connecting an artery to a vein, usually in the arm.
Why choose a fistula?
- The artery-to-vein connection increases blood flow, making the vein larger and stronger.
- This facilitates repeated needle insertions and ensures adequate blood flow for effective dialysis.
- A well-maintained fistula can last for many years.
Maturation time
After surgery, the fistula usually takes 1 to 3 months to develop before it can be used for dialysis. During this period, you may need to do exercises (such as squeezing a stress ball) to help it mature.
2/ Central Venous Catheter (CVC) : A Temporary but Risky Solution
A central venous catheter is a flexible tube inserted into a large vein, typically in the neck (jugular vein) or under the collarbone (subclavian vein). It is used in emergencies or when a fistula is not yet ready.
Benefits
- Can be used immediately, without a maturation period.
- Often serves as a temporary solution while waiting for a fistula to develop.
Disadvantages and Risks
- High risk of infection due to its external placement.
- Increased risk of blood clots (thrombosis).
- Can be fragile and limit physical activity.
BEST PRACTICES TO PROTECT YOUR FISTULA
Monitor Your Fistula Daily
- Check for a "thrill" (a vibration or pulsation) under your fingers—this indicates proper blood flow.
- Ensure the skin around the fistula is clean and free of redness, swelling, or pain.
- If bleeding continues for an extended period after dialysis, apply pressure with a sterile compress and contact your healthcare team if the bleeding persists.
Protect Your Fistula in Daily Life
- Avoid wearing watches, bracelets, or tight clothing on the fistula arm.
- Avoid blood pressure measurements or injections on that arm.
- Protect your arm from bumps or injuries (while gardening, doing DIY work, playing sports…).
Stimulate Your Fistula to Improve Its Function
- After surgery, perform regular hand exercises such as squeezing a stress ball to help the vein develop properly.
CARING FOR A CENTRAL VENOUS CATHETER
Essential Hygiene and Precautions
- Never touch the catheter site with unwashed hands.
- Keep the dressing clean and dry. Only change it with the help of a healthcare professional.
- Avoid pulling or twisting the catheter with your clothing or movements.
- During dialysis connections and disconnections, both you and your nurse should wear a mask to reduce infection risk.
WHEN SHOULD YOU CONTACT YOUR MEDICAL TEAM ?
Seek medical advice if you notice:
- No "thrill" or vibration in your fistula, which could indicate a blockage.
- Redness, swelling, pain, or unusual warmth at the vascular access site.
- Persistent bleeding after dialysis.
- Fever or unexplained discomfort, which may signal a catheter infection.
A well-maintained vascular access is the key to effective dialysis and improved comfort in daily life. By adopting these simple practices, you can reduce the risk of complications and extend the lifespan of your access. If you have any doubts or questions, do not hesitate to speak with your healthcare team.
Your health depends on your vigilance!
