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Vascular Access Q and A
Hemodialysis access or vascular access is a way for dialysis treatments to reach a person’s bloodstream when they need these treatments to clean impurities from their blood. This access allows blood to travel through soft tubes to the dialysis machine where it is cleaned as it passes through a special filter, called a dialyzer. When it is possible to do so, having a vascular access is preferable to using a catheter to receive dialysis, because it’s associated with significantly lower infection rates.
You should consider receiving a vascular access once your physician determines that your kidney disease has advanced to stage that requires dialysis to clean blood. Use of a vascular access is associated with lower infection rates than the use of a catheter.
Both a fistula and a graft are forms of a vascular access that enable a person to receive dialysis treatments. A fistula is an access made by joining an artery and vein in your arm. A graft is an access made by using a piece of soft tubing to join an artery and vein in your arm.
Either of these accesses can be placed during a minor surgery.
Your dialysis care team will check your access often to make sure it is working well. An access that is not working well may not clean your blood effectively. Your dialysis care team will give you specific instructions for how to care for your access and when to contact your physician.
Peripheral Arterial Disease (PAD) Q and A
Peripheral Arterial Disease (PAD) is a narrowing or blockage in a person’s arteries that obstructs blood flow in the legs.
The primary cause of PAD is atherosclerosis, or the buildup of plaque in the arteries.
Blockages can restrict blood flow to the muscles, causing muscle cramps, tightness or weakness, especially during activity. In the early stages of PAD, patients may not experience any symptoms.
The risk factors for PAD include smoking, high blood pressure, diabetes, high cholesterol, and being over the age 60. PAD patients are also at greater risk for heart attack and stroke.
Early detection and treatment are important to control the disease and allow patients a full selection of different treatment options. Family physicians, internists, physician assistants, nurse practitioners and vascular specialists can all diagnose PAD by examining a patient’s medical and family history, performing a physical exam, and conducting diagnostic tests.
Your physician will determine the best treatment option. These might include medication management and lifestyle changes or procedures to open the blockages, based on the results of an evaluation.