{"id":2481,"date":"2015-12-03T09:02:17","date_gmt":"2015-12-03T15:02:17","guid":{"rendered":"http:\/\/www.medradclinics.com\/?p=2481"},"modified":"2015-12-03T09:02:17","modified_gmt":"2015-12-03T15:02:17","slug":"maintenance-of-hemodialysis-accesses","status":"publish","type":"post","link":"https:\/\/www.medradclinics.com\/?p=2481","title":{"rendered":"Maintenance Of Hemodialysis Accesses."},"content":{"rendered":"

What Are Hemodialysis Accesses?<\/strong><\/h2>\n

The kidneys eliminate excess water and impurities from the body. When they fail the\u00a0body retains the impurities and water making\u00a0the patient sick. The best treatment for renal\u00a0failure is renal transplant, but for several reasons this is not always practicable. 2 substitutes, hemodialysis<\/strong> and peritoneal dialysis <\/strong>are available to keep patients alive.<\/p>\n

In peritoneal dialysis the membrane lining\u00a0the patient’s abdominal cavity exchanges the\u00a0impurities and excess water with a liquid called a dialysate injected into the cavity\u00a0through a catheter inserted into it.<\/p>\n

\"Dialysis

Dialysis catheter<\/p><\/div>\n

In hemodialysis,\u00a0blood\u00a0drawn from\u00a0the patient\u00a0is passed\u00a0through a\u00a0machine that removes the\u00a0impurities\u00a0and excess\u00a0water and returned to\u00a0the patient’s\u00a0blood stream. A catheter<\/strong> with 2 channels is\u00a0inserted into a large vein in the patient by an\u00a0interventional radiologist and blood is drawn through one channel to the dialyzing machine\u00a0and returned to the patient from the machine\u00a0through the second channel.\u00a0In another method of hemodialysis, surgeons\u00a0connect an artery to a vein either directly in\u00a0arteriovenous fistulas (AVFs)<\/strong> or by interposing an artificial tube between them in ar<\/strong>teriovenous grafts (AVGs).<\/strong><\/p>\n

 <\/p>\n

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 <\/p>\n

\"AV

AV Fistula<\/p><\/div>\n

\"AV

AV Graft<\/p><\/div>\n

Blood is drawn from and returned to the patient through these channels after passing\u00a0through a dialyzing machine. Catheters,\u00a0AVFs, and AVGs are all hemodialysis ac<\/strong>cesses,<\/strong> but AVFs and AVGs are more desirable than dialysis catheters.<\/strong><\/p>\n

 <\/p>\n

 <\/p>\n

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 <\/p>\n

Do Hemodialysis Accesses Fail?<\/strong><\/h2>\n

Yes, they fail or malfunction, but there several things interventional radiologists do to restore their function.\u00a0The dialysis catheter may leak, break, obstruct, or become infected. Usually, every effort is made to preserve the access unless doing so imperils a patient. When that is the\u00a0case, the catheter may be exchanged for a\u00a0new one using the same venous access, or a\u00a0new venous access created if using the old\u00a0access is unwise or not practicable.<\/p>\n

AVFs and AVGs may fail to ‘mature’ after\u00a0their creation and be unusable. Interventional\u00a0radiologists can assist their maturation with\u00a0creative interventions. But their commonest problem when mature is their unpredictable,\u00a0sudden cessation to function. This is often\u00a0due to a narrowing in their venous limb that develops over time, slowly diminishing the\u00a0flow of blood through the access until it suddenly ceases. The blood in the graft and any\u00a0length of vein before the obstruction congeals, completing the problem. Interventional radiologists have ways of reopening the\u00a0venous narrowing, removing the blood clot\u00a0and restoring function to the access. Sometimes these accesses fail because they develop large bulges called aneurysms from being\u00a0punctured repeatedly. These can also be\u00a0treated with stents to prolong the life of the\u00a0access. To avoid these surprises, the accesses\u00a0are often monitored periodically with ultrasound or angiography.<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

What Are Hemodialysis Accesses? The kidneys eliminate excess water and impurities from the body. When they fail the\u00a0body retains the impurities and water making\u00a0the patient sick. The best treatment for renal\u00a0failure is renal transplant, but for several reasons this is not always practicable. 2 substitutes, hemodialysis and peritoneal dialysis are available to keep patients alive. […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2481","post","type-post","status-publish","format-standard","hentry","category-uncategorized","pmpro-has-access"],"_links":{"self":[{"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/posts\/2481","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2481"}],"version-history":[{"count":1,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/posts\/2481\/revisions"}],"predecessor-version":[{"id":2482,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/posts\/2481\/revisions\/2482"}],"wp:attachment":[{"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2481"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2481"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2481"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}