Hemodialysis Vascular Access: Care Instructions

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Hemodialysis, or dialysis, is the use of a machine to remove wastes from your blood. You need it if your kidneys are not able to remove wastes on their own. A dialysis access is the place in your arm, or sometimes in your leg, where a doctor creates a blood vessel that carries a large flow of blood.

Your doctor creates an access during a minor surgery. You need to take care of your access to keep it working and to prevent infection.

When you have dialysis, two needles are placed in this blood vessel and are connected to the dialysis machine. Your blood flows out of one needle and into the machine to be cleaned. Then your cleaned blood flows back into your body through the other needle. Sometimes a doctor makes a short-term access through a tube, called a catheter, placed in your neck, upper chest, or groin.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • After your doctor creates an access, keep it dry for at least 2 days.
  • Squeeze a soft ball or other object as instructed after the access is placed. This will help blood flow through the access and help prevent blood clots.
  • After you have dialysis, check to see if the access bleeds or swells. Let your doctor know if your arm bleeds or swells.
  • Do not lift anything heavy with the arm that has the access.
  • Do not bump your arm.
  • Don't wear tight clothing or jewelry over the access.
  • Don't sleep with your access arm under your body.
  • Have blood drawn or blood pressure taken from your other arm.
  • Keep the access clean and dry.
  • Don't put cream or lotion on or near the access.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness around the access.
    • Red streaks leading from the access.
    • Pus draining from the access.
    • A fever.
  • You do not feel a pulse in your access.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.