Dialysis Access Visalia CA
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for simple and complex dialysis access cases!
What is Dialysis Access?
As the name suggests, dialysis access is the creation of an entry point between the dialysis machine and your body. This sounds simple enough, but effective dialysis requires careful manipulation of your vascular anatomy that is best left to a Vascular Specialist.
Our dialysis access center is conveniently located in downtown Visalia, California at the corner of Locust Street and East Acequia Avenue. Schedule your visit today!
Dialysis can either work outside the body via hemodialysis or inside the body via peritoneal dialysis. In either case, the goal of dialysis is to clean the blood often: 3-5x per week for hemodialysis or 3-5x per day for peritoneal dialysis. 
Hemodialysis – blood is directly withdrawn from the body. This blood is cleaned in a dialysis machine before being replaced back into the body.
Peritoneal dialysis – fluid is injected into the open cavity of the abdomen known as the “peritoneum.” This fluid stays in the cavity for multiple hours while slowly drawing toxins out of the blood, after which, the fluid and toxins are removed.
Do I Need Dialysis?
At some point, you and your doctor will explore the treatment options of kidney transplant, dialysis, and conservative management.  If dialysis is selected or necessary until transplant can happen, you will choose between hemodialysis or peritoneal dialysis. When possible, doctors will plan the corresponding dialysis access procedure weeks to months before starting dialysis treatments. 
Hemodialysis (left) is done via the forearm vs. peritoneal dialysis (right), which is done via the abdomen.
Dialysis Access in Visalia, CA
Hemodialysis Access Methods
A similar option to the AV fistula is the arteriovenous graft, also called an AV graft. The graft option connects an artery to a special tube which then connects to a vein. This tube is placed under the skin, and the dialysis machine is connected directly into the special tube. The graft option is not quite as robust or as safe as a fistula, but it’s a great option for patients that don’t meet the anatomical requirements for fistula. 
Intravenous Hemodialysis Access
Peritoneal Dialysis Access Methods
Arteriovenous (AV) fistula created to support dialysis.
Arteriovenous (AV) graft implanted to support dialysis.
Central venous catheter placed for intravenous hemodialysis.
Dialysis Access in Visalia, CA
Recent clinical studies have confirmed that hemodialysis and peritoneal dialysis are equally effective when it comes to patient survival.  Still, there are a few considerations that may cause you and your physician to choose a particular dialysis access approach over others.
Timeliness – You and your doctor should consider how soon you need dialysis. If you need immediate treatment, intravenous access may be your only option. In contrast, graft access usually requires 2 to 3 weeks after surgery before proper dialysis can begin, and fistula often requires 2 to 3 months. However, there are new methods that might allow shorter delay until dialysis. 
Risk of Infection – Infection rates vary significantly across these options. Fistula access has the lowest chance of infection, while graft access leads to infection nearly twice as often, and intravenous access causes nearly three times as many infections as fistula. 
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 Levey, A. S., & Coresh, J. (2012). Chronic kidney disease. The Lancet, 379(9811), 165–180.
 Slinin, Y., Greer, N., Ishani, A., MacDonald, R., Olson, C., Rutks, I., & Wilt, T. J. (2015). Timing of Dialysis Initiation, Duration and Frequency of Hemodialysis Sessions, and Membrane Flux: A Systematic Review for a KDOQI Clinical Practice Guideline. American Journal of Kidney Diseases, 66(5), 823–836.
 Rivara, M. B., & Mehrotra, R. (2017). Timing of Dialysis Initiation: What Has Changed Since IDEAL? Seminars in Nephrology, 37(2), 181–193.
 Wong S. P. Y., McFarland L. V., Liu C-F., … O’Hare A. M. (2019). Care Practices for Patients With Advanced Kidney Disease Who Forgo Maintenance Dialysis. JAMA Internal Medicine, 179(3):305-313.
 Kukita, K., Ohira, S., Amano, I., Naito, H., Azuma, N., … Ikeda, K. (2015). 2011 update Japanese Society for Dialysis Therapy Guidelines of Vascular Access Construction and Repair for Chronic Hemodialysis. Therapeutic Apheresis and Dialysis, 19, 1–39.
 Balraj, P.C., Hodari-Gupta, A., Haddad, G., (2017). Endovascular and Open Vascular Reconstruction: A Practical Approach, 365-370.
 Pisoni, R. L., Zepel, L., Port, F. K., & Robinson, B. M. (2015). Trends in US Vascular Access Use, Patient Preferences, and Related Practices: An Update From the US DOPPS Practice Monitor With International Comparisons. American Journal of Kidney Diseases, 65(6), 905–915.
 Chaudhary, K., Sangha, H., & Khanna, R. (2010). Peritoneal Dialysis First: Rationale. Clinical Journal of the American Society of Nephrology, 6(2), 447–456.
 Schmidli, J., Widmer, M. K., Basile, C., de Donato, G., Gallieni, M., Gibbons, C. P., … Roca-Tey, R. (2018). Editor’s Choice – Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). European Journal of Vascular and Endovascular Surgery, 55(6), 757–818.
 Xue, H., Ix, J. H., Wang, W., Brunelli, S. M., Lazarus, M., Hakim, R., & Lacson, E. (2013). Hemodialysis Access Usage Patterns in the Incident Dialysis Year and Associated Catheter-Related Complications. American Journal of Kidney Diseases, 61(1), 123–130.
 Wong, B., Ravani, P., Oliver, M. J., Holroyd-Leduc, J., Venturato, L., Garg, A. X., & Quinn, R. R. (2018). Comparison of Patient Survival Between Hemodialysis and Peritoneal Dialysis Among Patients Eligible for Both Modalities. American Journal of Kidney Diseases, 71(3), 344–351.
 Ravani, P., Gillespie, B. W., Quinn, R. R., MacRae, J., Manns, B., Mendelssohn, D., … Pisoni, R. (2013). Temporal Risk Profile for Infectious and Noninfectious Complications of Hemodialysis Access. Journal of the American Society of Nephrology, 24(10), 1668–1677.
 Murad, M. H., Elamin, M. B., Sidawy, A. N., Malaga, G., Rizvi, A. Z., Flynn, D. N., … Montori, V. M. (2008). Autogenous versus prosthetic vascular access for hemodialysis: A systematic review and meta-analysis. Journal of Vascular Surgery, 48(5), S34–S47.
 Murphy, E. A., Ross, R. A., Jones, R. G., Gandy, S. J., Aristokleous, N., Salsano, M., … Houston, J. G. (2017). Imaging in Vascular Access. Cardiovascular Engineering and Technology, 8(3), 255–272.
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