血液透析的访问

(Chronic kidney/renal disease)

Over 660,000 Americans have end stage kidney disease (ESRD). 最常见的 causes of kidney disease are high blood pressure and diabetes. 当你的 kidneys fail, your body is unable to remove chemical toxins and excess 你身体里的水. The treatment for kidney failure is dialysis or kidney transplantation which can take years to receive.

Hemodialysis (HD) takes the place of your kidneys by removing wastes and extra chemicals from your body and restoring normal pH balance. 一些病人 may be candidates for peritoneal dialysis but HD is often more common. Catheters underneath the skin (Permacath/Vascath) can be used as a short term access for HD, but it is not preferable for most patients. 这些 catheters must be kept clean and dry which can complicate hygiene routines 比如洗澡.

To create a more long-term HD access for you, a vascular surgeon needs to perform a surgical procedure. This procedure connects an artery and a vein of the arm with the intent of making the vein big enough for the dialysis catheters to perform HD. This surgically connected artery and vein is called an “AV fistula.” Sometimes, surgeons use a prosthetic graft instead of a fistula which is called an “AV graft.” This fistula or graft then becomes the access site for HD.

Unfortunately, these AV fistulas and grafts can become clogged or narrowed over time making HD difficult or impossible. Just like a car, AV fistulas and grafts require routine maintenance to ensure long-term usage.

Washington 医院 offers another option for patients with dialysis access problems called the HeRO graft device. The HeRO Graft (Hemodialysis Reliable Outflow) is a fully subcutaneous AV access solution clinically proven to maintain long-term access for hemodialysis patients with central venous 狭窄. Our surgeons have inserted more HeRO graft devices than any 其他当地医院.

If you have been newly diagnosed with ESRD or have been on dialysis using a catheter, speak to your primary doctor or Nephrologist about a referral to one of our Vascular Surgeons to discuss your surgical HD access options.