What are the different types of dialysis access?
Find out which dialysis access works best for you. Understand how each option works, how long they take to heal, and what to think about when making your choice.
Choosing a dialysis access
There are different types of dialysis access options to consider for treatment. Understanding your options and choosing the best fit for you can help you stay healthy and feel your best. Your care team can help determine which access type is right for your treatment and health needs.
Types of dialysis access
Peritoneal dialysis catheter
Access is created by placing a flexible tube in your abdomen. A small piece of tubing is left outside the body that’s covered when not being used.
USED FOR:
Peritoneal dialysis (PD) only
HEALING TIME BEFORE USE:
A few days to two weeks, depending on the need to start treatment
Things to consider:
- This is the only access type for PD.
- Needles are not needed for dialysis.
- Access site must be kept clean.
- A clean home treatment area is important to avoid infection.
- A backup arteriovenous (AV) fistula may be helpful in case hemodialysis is ever needed.
Arteriovenous Fistula (AVF)
Access is formed by joining a vein with an artery in your arm.
USED FOR:
Hemodialysis (in-center or home)
HEALING TIME BEFORE USE:
Six to twelve weeks
Things to consider:
- A fistula is the best choice for hemodialysis.
- It is the most natural access since it uses your own blood vessels.
- A fistula allows for the best blood flow.
- It has the lowest chance of infection and clotting.
- It is possible to do fistula surgery after starting hemodialysis.
Arteriovenous Graft (AVG)
Access is formed by connecting a vein and artery in your arm with a piece of soft tubing.
USED FOR:
Hemodialysis (in-center or home)
HEALING TIME BEFORE USE:
Immediate to up to three weeks
Things to consider:
- A graft is a great choice if your veins are too small or weak for a fistula.
- It offers better blood flow and a lower chance of infection than a hemodialysis catheter.
- If your graft fails, you may be able to get a fistula or a new graft in another location.
Hemodialysis Catheter
Access is created by placing a tube into a blood vessel in your chest or groin that goes directly to your heart. This access can be used temporarily while a graft or fistula is healing.
USED FOR:
Hemodialysis (in-center or home) but not recommended long term
HEALING TIME BEFORE USE:
Can be used immediately
Things to consider:
- A hemodialysis catheter has a higher risk of infection and clotting.
- It can be used temporarily until fistula or graft surgery is performed and the new access is ready to use.
- The access site must be kept dry, which limits bathing options, and swimming is not recommended.
Comparing the access options
We’re here to help
Talk to your care team to determine the right type of access for you.
This serves only as a guide. Talk with your healthcare provider for more information based on your health needs.
Julie Dominguez, MD
Vice President, Medical Office, Interwell Health
Julie Dominguez, MD, is a nephrologist with extensive experience in private practice nephrology and medical education. At Interwell Health, she helps advance high-quality kidney care programs that support patients and clinicians. Dr. Dominguez earned her medical degree from the University of Texas Southwestern Medical Center, completed her Internal Medicine residency at Duke University, and completed her Nephrology fellowship at the University of California San Diego.