Haemodialysis needs a way to take blood out of the body and return it. This is called vascular access. There are three types.
| Type | What it is |
|---|---|
| Fistula | A surgeon joins an artery to a vein, usually in the arm. It needs some weeks to become ready. |
| Graft | A surgeon joins an artery to a vein with a soft tube. |
| Catheter | A tube goes into a large vein, usually in the neck or chest. It can be used at once. |
Why the type matters
Renal teams usually prefer a fistula for long-term haemodialysis. A catheter is often used at the start or in an emergency. A 2022 study found that fewer than 2 percent of patients in Kenya started haemodialysis with a fistula.
Ask your renal team which access is right for you. Ask early, because a fistula needs time to become ready.
Look after a fistula or graft
- Do not let anyone take blood or blood pressure from that arm.
- Do not wear tight clothes or a watch on that arm.
- Keep the arm clean.
- Feel for the buzz (thrill) every day. Tell your unit at once if it stops.
Look after a catheter
- Keep the dressing clean and dry.
- Do not swim, and do not let the catheter get wet.
- Tell your unit at once if you have a fever, redness or pain at the site.
Costs
The SHA haemodialysis package includes insertion and removal of a temporary catheter. Ask your unit what SHA pays for fistula surgery.
Sources and review
Written by Editorial team. Not yet reviewed.
- Maritim, Twahir, Davids. Global Dialysis Perspective: Kenya. Kidney360, 2022.
This guide is general information. It is not medical advice. Editorial policy.