Medicare's "You Can Live: Your Guide For Living With Kidney Failure"

There are three kinds of access—Fistula, Graft, and Catheter.“There are threekinds of access—Fistula, Graft, andCatheter.”• A fistula or arteriovenous fistula (AVF) surgically connects anartery and a vein. A fistula needs weeks to months to heal and“mature” before it can be used. When a fistula matures, itbecomes larger and stronger and better for dialysis. It’sconsidered the best access because it lasts longer, has fewerproblems, gives better hemodialysis results, and can lower therisk of infection. With a fistula, you can improve your qualityof life and length of life. A fistula isn’t right for everyone, butyou should be evaluated for a fistula, and given one if it’s thebest access for you. It’s best to get a fistula before you needdialysis so that it can be ready for use when you need it.• A graft or arteriovenous graft (AVG) uses special tubing tosurgically connect an artery and vein. A graft needs lesshealing time than a fistula. However, a graft must bereplaced every so often.• A catheter makes a temporary access by inserting a soft,flexible tube into a vein in the neck, chest, or groin. Acatheter can be used as soon as it’s in place.Fistula Access Cross-SectionFor each hemodialysis treatment, two needles are put into youraccess. Each needle is connected to a plastic tube. One line takesthe blood with wastes out of your body. The other tube carriesthe clean blood back into your body.8