While healthy kidneys have several functions in the body, the most well-known job is to remove toxins and extra fluid from the blood and expel them from the body as urine. As they are filtering, the kidneys release hormones into the body that are responsible for regulating blood pressure, as well as controlling and stimulating the number of red blood cells that are produced. When kidney function goes below 10% to 15% and are no longer working effectively, waste products and fluid build-up in the blood. This malfunction causes toxins to build up in the body along with excess fluid. Without healthy and functioning kidneys, they can easily cause problems for the entire body. Fortunately, we live in a time when there are treatments and medicines that can replace the functions of the kidneys and keep the body alive.
One type of renal replacement therapy treatment that replaces kidney function is hemodialysis. As defined by UCSF Department of Surgery, hemodialysis is a treatment for kidney failure that uses a machine to send the patients’ blood through a filter outside of the body called a dialyzer. The access is a surgically created vein used to remove and return blood during hemodialysis. The blood goes through a needle or catheter, a few ounces at a time, and travels through tubing that takes it to the dialyzer. Inside the dialyzer, the blood flows through thin fibers that filters out the waste and extra fluid while the machine returns the filtered blood to the body through different tubing.
Hemodialysis catheters are catheters inserted into a vein in the neck, chest, or near the groin, used for attaining access for hemodialysis vascular access and apheresis therapy. Apheresis therapy is the process of removing a specific portion of the blood while returning the remainder of the blood to the patient. The distal end of a hemodialysis catheter is inserted into a central vein, the proximal end of the catheter is connected to a hemodialysis machine to filter blood. Dialysis catheters usually have two lumens attached to two ports. One port identifies as the “arterial” lumen that draws blood from the body, while the other port identifies as the “venous” lumen for the return of blood from the dialysis machine to the patient. The lumen on the dialysis catheter has a large diameter to provide a high rate of flow, which is essential in the dialysis process. When therapy begins, blood is removed for dialysis, filtered through a dialyzer, and returned to the body. Pumps coupled to the hemodialysis mechanism are typically utilized for causing the blood to flow through circuitous path.
Types of Vascular Access for Hemodialysis
There are three different types of vascular access ports for hemodialysis, arteriovenous (AV) fistulas, and arteriovenous (AV) grafts (both designed for long-term use), and hemodialysis catheters (designed for long-term and short-term use).
To achieve dialysis through an arteriovenous fistulas, a surgeon will link a patient’s vein to an artery under the skin of a patient’s arm. The AV fistula is placed into the forearm or upper arm, where the fistula causes extra pressure and extra blood flow into the vein, creating more strength. A fistula is considered the “gold standard” because it is made only of a person’s own blood vessels. Unlike other vascular access ports, AV fistulas provide good blood flow for dialysis, last longer, and are less likely to become infected or cause blood clots.
An AV graft is a looped, plastic tube that links an artery to a vein under the skin of a patients arm with a piece of synthetic or bovine vein. Because the tissue is not the patients, a graft is more prone to infection and blood clots that an AV fistula.
A venous catheter is a Y-shaped tube that is inserted into a large vein in either the neck, chest, or leg near the groin. Venous catheters are only meant for short-term use; allowing them to be beneficial for patients who need to start hemodialysis right away. However, long-term venous catheters may be used in hemodialysis patients without a functioning AV Fistula or graft. They are just less commonly used in patients having red blood cell exchanges or apheresis, due to poor AV access creation.
Here at Health Line International Corp., we manufacturer and distribute high-quality, affordable hemodialysis catheter kits in straight, curved, silicone, and polyurethane configurations for hemodialysis and apheresis treatment. Indicated for temporary, chronic, and permanent intravenous therapies, our tunneled and non-tunneled hemodialysis catheter kits meet clinician and patient needs while decreasing hemodialysis and apheresis therapy time.
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Hyperarts, R. (n.d.). Vascular access for hemodialysis. https://surgery.ucsf.edu/conditions–procedures/vascular-access-for-hemodialysis.aspx
“Vascular Access for Hemodialysis.” Home, lifeoptions.org/living-with-kidney-failure/vascular-access/.
What is hemodialysis. (n.d.).https://www.davita.com/treatment-services/dialysis/in-center-hemodialysis/what-is-hemodialysis