Dialysis Access: What You Need to Know

Dialysis is a treatment for patients with kidney failure. This treatment completes the functions healthy kidneys usually perform, including removing waste and regulating the levels of certain chemicals in the blood. According to the National Kidney Foundation, “In 2017, 746,557 Americans had kidney failure, and needed dialysis or a kidney transplant to survive.”

The physicians at Vascular & Vein Institute of Siouxland provide a full spectrum of dialysis access care including fistula creations, fistulograms, and catheter placements or replacements.

Fistula Creations

Creating a fistula is considered one of the best options for dialysis access due to its low risk of infection. In fact, the National Kidney Foundation recommends fistulas as the preferred choice for permanent vascular access. This procedure is done by joining an artery and vein, usually in the patient’s non-dominant forearm, to make a bigger blood vessel that can support a higher level of blood flow. A higher level of blood flow is needed for effective dialysis treatment and can help to decrease treatment time.


The physicians at Vascular & Vein Institute of Siouxland use fistulograms to assess fistulas, a type of dialysis access discussed above. This procedure can help to identify problems caused by repeated dialysis treatments such as scarring or narrowing of the vein.

To perform a fistulogram, your physician will insert a catheter into your fistula and use x-ray imaging to guide it through your vein. Once the catheter is in position, they will inject a contrast material to help uncover potential blockages or damage and take x-ray images.

If blockages or narrowing are discovered, your physician may recommend a minimally invasive treatment such as catheter-directed thrombolysis or angioplasty to restore blood flow.

Catheter Placements or Replacements

The physicians at Vascular & Vein Institute of Siouxland can place a peritoneal dialysis catheter, a different type of dialysis access. The catheter, called a cannula, is placed in the patient’s abdomen and allows the lining of the abdomen to filter blood. Unlike other types of dialysis, this access allows the patient to complete their dialysis treatments at home.