Hemodialysis, also know as dialysis, is the commonly used treatment for kidney failure. A dialysis machine is a artificial kidney which will cleanses the blood. In dialysis, blood is drawn from the patient into a dialysis machine, then circulation of the blood through the machine, and then returned the blood to the patient. 2 needles were inserted into the patient’s the blood stream to let this process to occur. Hemodialysis is usually performed 3 times a week and the reason of vascular access is to offer reliable sites where the bloodstream can be simply accessed each time. There are 3 major types of vascular access:

  • Arteriovenous fistula

  • Arteriovenous graft

  • Venous catheter

The great majority of vascular accesses is created in the arm, but they are also been created in the leg.


  • Initially doctor will create an arteriovenous fistula by building a connection in between an artery (which will carry blood away from the heart) and a vein (which will carry blood back to the heart).

  • This artificial link allows the vein to become much bigger and for the walls of the vein to be thickened, this process is termed as maturation. A mature fistula makes it convenient for the vein to be punctured constantly for dialysis. Maturation typically takes 3 to 6 months to happen, but in unusual cases, it can take up to one year.

  • This makes advance planning for an arteriovenous fistula as important. When a patient is felt to be around a year away from requiring dialysis, the patient must be referred for assessment for probable creation of an arteriovenous fistula.

  • An arteriovenous fistula is the ideal type of vascular access because of low rate of infection and clot formation, resulting in better long life than other types of vascular access.

  • Yet, everyone is not a good or right candidate for an arteriovenous fistula, mainly older patients and patients with small veins.