When kidney function is insufficient or has failed, and the body can no longer remove excess water and toxins normally,
dialysis is needed to take over part of normal kidney function. The main forms of dialysis today include:
Peritoneal dialysis: uses the peritoneum inside the abdominal cavity to take over part of kidney function. Through an abdominal catheter placed beforehand, dialysis fluid is introduced into the abdominal cavity and, after dialysis, drained out through the same catheter.
Hemodialysis: the body’s blood is led to a hemodialysis machine, which removes excess fluid and toxins, and the dialyzed blood is returned to the body. Hemodialysis access is the connecting route between the body and the hemodialysis machine.
Hemodialysis access includes:
Double lumen catheter: provides a quickly usable short-term dialysis access for patients who need dialysis urgently. The catheter has no cuff and is prone to infection, so early removal is usually advised to reduce related complications.
Tunneled-cuffed catheter (TCC): also called PERcath / TCC / Hickman catheter, provides a short- to medium-term dialysis access. The catheter has a cuff, which lowers the chance of infection, but it is still advisable to complete a long-term dialysis access as soon as possible and remove the catheter early, to reduce related complications.
** There are now several ways to reduce the chance of patients needing a catheter, and thereby lower related complications.
Native arteriovenous fistula (AVF) / arteriovenous graft (AVG): a long-term dialysis access. The vascular surgeon chooses a suitable artery and vein and bridges them surgically, either with the patient’s own vessels (native fistula) or with a synthetic graft. It needs regular follow-up and maintenance to keep the access open and dialysis quality good.
