Dialysis Access: What Patients Should Know Before Hemodialysis

If you or a loved one has been told that hemodialysis may be needed, one of the first steps is establishing reliable dialysis access. Many patients are referred for dialysis access evaluation weeks or months before dialysis begins, while others require evaluation because an existing access is no longer functioning properly.

At BASS Medical Group, our nephrologists help patients with chronic kidney disease plan for dialysis and coordinate the appropriate dialysis access care when needed. Patients may also be referred to nephrology by a primary care or internal medicine provider when kidney function is declining or more specialized kidney care is needed.

What Is Dialysis Access?

Dialysis access is a connection that allows blood to be safely removed from the body, filtered through a dialysis machine, and returned during hemodialysis treatment.

There are three primary types of dialysis access:

Arteriovenous (AV) Fistula

An AV fistula is created by connecting an artery to a vein, usually in the arm. Over time, the vein enlarges and strengthens, making it suitable for repeated dialysis treatments.

Many physicians consider an AV fistula the preferred long-term dialysis access option because it uses the patient's own blood vessels.

Arteriovenous (AV) Graft

An AV graft uses a specialized synthetic tube to connect an artery and vein when the patient's veins are not suitable for a fistula.

AV grafts can often be used sooner than fistulas but may require additional maintenance over time.

Dialysis Catheter

A dialysis catheter is a tube placed into a large vein, typically in the neck or chest. Catheters are commonly used when dialysis must begin quickly or while waiting for a fistula or graft to mature.

Who Needs Dialysis Access?

Patients with advanced chronic kidney disease (CKD) or kidney failure may require dialysis access if hemodialysis is recommended.

A primary care provider or internal medicine physician may refer a patient to a nephrologist when kidney function begins to decline. If dialysis becomes necessary, the nephrologist can help coordinate access planning and ongoing kidney care.

Your nephrologist may recommend dialysis access evaluation if:

• Kidney function is declining
• Dialysis is expected in the near future
• An existing fistula or graft is not functioning properly
• A dialysis catheter is needed
• Your dialysis access requires evaluation, repair, or maintenance

Early evaluation often provides more options and may help avoid treatment delays.

Why Is Early Planning Important?

Many patients are surprised to learn that some forms of dialysis access require time before they can be used.

For example, AV fistulas often need time to mature before they are ready for dialysis treatments. Waiting until dialysis is urgently needed may limit available options and increase reliance on temporary dialysis catheters.

Working with a nephrologist early allows patients to better understand their kidney function, prepare for the possibility of dialysis, and coordinate dialysis access before treatment is needed.

What Happens During Dialysis Access Planning?

Dialysis access planning often begins with your nephrologist, who will review your kidney function, overall health, and anticipated dialysis needs.

Depending on your situation, your care team may:

• Review your medical history
• Discuss your kidney disease and dialysis needs
• Evaluate your veins and arteries
• Perform vascular ultrasound mapping
• Recommend the most appropriate access option
• Discuss timing, recovery, and follow-up care

The goal is to establish reliable access that supports your long-term dialysis treatment.

Dialysis Access Care at BASS Medical Group

BASS Medical Group provides coordinated care for patients with chronic kidney disease and other kidney conditions. Our nephrologists work with patients throughout the progression of kidney disease, including planning for dialysis when appropriate.

Dialysis access care may include:

• Dialysis access evaluation
• AV fistula or graft planning
• Dialysis catheter coordination
• Access monitoring and maintenance
• Vascular imaging when needed
• Ongoing nephrology follow-up

Treatment recommendations are based on your kidney function, medical history, anatomy, and dialysis requirements.

When Should You Schedule an Evaluation?

Talk with your primary care provider, internal medicine physician, or nephrologist if:

• Your kidney function is declining
• You have advanced chronic kidney disease
• Dialysis may be needed in the future
• You have been referred for dialysis access
• Your current access is not functioning properly
• You have concerns about your dialysis treatment or access

Early nephrology care can help patients understand their options and prepare for dialysis before it becomes urgently necessary.

Kidney and Dialysis Care at BASS Medical Group

BASS Medical Group provides nephrology care for patients with chronic kidney disease, kidney failure, and other kidney conditions throughout the East Bay.

If you have been diagnosed with kidney disease or your primary care or internal medicine provider has recommended a nephrology evaluation, our team can help assess your kidney health, discuss treatment options, and coordinate dialysis care when needed.

Request an appointment today to learn more about nephrology and dialysis care at BASS Medical Group.