Vascular access for the hemodialysis process is gained through an arteriovenous (AV) fistula, arteriovenous (AV) graft, or dialysis catheter (TDC). AV fistulas and AV grafts are designed for long-term use, while dialysis catheters are designed for short-time use. There exist two types of dialysis catheters: tunneled and non-tunneled dialysis catheters. Non-tunneled catheters may be cuffed or non-cuffed. Hemodialysis catheter is a soft tube inserted into a vein either in the neck, chest, or leg (close to groin). It is divided into two after the tube exits the body.
Vascular access is of importance to the treatment. It is likely to be vulnerable to infections and clotting of blood, which are generally the leading cause of catheter dysfunction. A majority of hemodialysis catheters are inserted and fixed onto the anterior chest wall when the patient holds a supine position. Also, according to NKF-KDOQI (National Kidney Foundation – Kidney Disease Outcomes Quality Initiative), the most preferred vascular access site is the right internal jugular vein (RIJV) when the tunneled central venous catheter is used. Other vascular access options include left internal jugular vein, femoral vein, external jugular vein, subclavian vein, transhepatic accesses, and translumbar accesses.
Hemodialysis is a life-saving intervention for patients with end-stage renal disease (ESRD). Patients with renal disease are affected by progressive loss in the liver functioning. It eventually becomes necessary for the patient to opt for dialysis treatment to sustain healthy life. ESRD is generally the end stage of chronic kidney disease (CKD), which has high prevalence worldwide. Hemodialysis is an alternative for numerous vital functions of kidneys. The dialysis machine itself is termed to be as an artificial kidney. It is generally used for removal of excess content of water and waste products or impurities from kidneys to filter patient’s blood when kidneys are damaged or dysfunctional. The dialysis machine brings about filtration of blood using a dialyzer, while removal of the blood (containing impurities or waste products) and returning of the filtered blood to the patient is brought about by surgical vascular access.