Your access is your lifeline.

When your kidneys fail and can no longer remove waste from your blood, dialysis treatment can do this for you. This requires that you have a dialysis access - either a catheter for peritoneal dialysis (PD) or a vascular access for hemodialysis (HD).

Unfortunately, patients may experience difficulty with their access. Each year, a typical dialysis patient requires at least one access intervention. Access problems often result in missed dialysis treatments and can lead to hospitalization. Your physician can determine from routine monitoring whether your access is allowing for successful dialysis.

A New Solution to Access Placement and Interventional Access Care

If your access site needed attention in the past, you might have spent several days at the hospital or waited for hours in an outpatient surgery facility where other types of procedures were also performed. Our access center is dedicated to assisting dialysis patients with access issues in a safe, clean, and efficient manner. Our primary goal is to obtain the best possible results for you.

Maintaining Your Access

The most common vascular access problem is narrowing of your access or of the blood vessel attached to it, which is usually a vein. This narrowing is called "stenosis." Stenosis can lead to clotting of your access. If this happens, your dialysis treatments will not be effective, and your access may eventually clot.

To prevent clotting of your access, your doctor will monitor its function routinely to detect any problems. The good news is that access narrowing, or stenosis, can be successfully treated. If your doctor suspects stenosis, you may be referred to our access center for evaluation and, if necessary, treatment.

The treatment for stenosis of the access is called "balloon angioplasty." The procedure is quick, easy, and effective, so dialysis can be successfully resumed.

What to Expect from an Access Procedure

•	Your dialysis unit or nephrologist may refer you to the access center and make an appointment for you.
•	You should dress comfortably and bring your insurance card.
•	When you arrive, a nurse will interview you and help you complete the necessary paperwork.
•	The physicians and nurses at the center are specially trained to evaluate and manage dialysis access problems. They will work closely with your doctor.
•	Your access will be examined, your vital signs (e.g. blood pressure) will be taken, and your medical history will be reviewed. This information is important in determining the best appraoch for resolving your access problem.
•	The doctor performing the procedure will discuss with you the best choice of medications to make you comfortable during the procedure.
•	Your treatment will take place in a sterile procedure room designed specifically to manage end-stage renal disease (ESRD) patients and their access site issues. Generally, the total evaluation and treatment can be completed using only one or two needles.
•	Most procedures take less than 45 minutes.
•	After spending a short time in the recovery area, you will be given instructions for any required follow-up care.
•	You will then be able to return home or to dialysis treatment and resume your normal schedule.
•	A complete report will be sent to your doctor and your dialysis unit.

Types of Treatment Procedures

Balloon Angioplasty: This procedure treats the most common access problem, which is the narrowing, or stenosis, of the access's opening or of the blood vessel attached to it. If stenosis is detected before clotting occurs, a balloon angioplasty can be performed. Successful angioplasty widens teh access opening and prevent clotting.

The first step is to inject dye into the access site to determine the extent of the narrowing. If significant narrowing is discovered, a small balloon attached to a thin, flexible tube called a "catheter" is inserted in the access. This expands or stretches the vessel wall, making it possible for blood to flow more freely and decreases the chances of access clotting.

Declotting: If your access does stop flowing, it means that blood has clotted. This is treated with a procedure similar to angioplasty - the only difference is that instead of stretching the vessel wall, the blood clot within the access is removed.

Catheter Placement: If the access is clotted, it may be impossible to open it and restore blood flow. When this happens, the physician may need to insert a catheter until other arrangements can be made.

We Go the Extra Mile

Having your access repaired quickly is very important to your health and well being. If you need transportation, we can help you make arrangements. If you require a dialysis treatment after your access procedure, the staff will help arrange for your return to the dialysis center.