There are two primary forms of dialysis:
Hemodialysis of the blood
Hemodialysis occurs with a machine that functions as an artificial kidney to filter and clean the blood. Access to the blood is essential for hemodialysis. When blood is filtered through hemodialysis, the blood is filtered through a machine called a dialyzer. The dialyzer has two parts: one for blood and one for a cleanser. A thin membrane separates the two parts, and the blood and proteins (too large to pass through the filter) are returned to the body while the smaller waste products in the blood (potassium, urea, creatinine, and extra fluids, for example) pass through the filter and are removed from the blood.
A dialysis catheter is a thin tube with two parts (venous and arterial) that goes into a single vein for the purpose of filtering the blood. The arterial lumen draws the blood from the body into the hemodialysis machine. After the blood is filtered, the venous lumen returns filtered blood from the machine back to the body.
We place dialysis catheters which are then managed by your nephrologist and dialysis center.
Fistula-based hemodialysis occurs through a procedure that connects an artery to a vein, usually in the wrist, forearm, or upper arm. The additional arterial flow to the vein causes the vein to grow larger and stronger and makes it easier to gain access to the blood vessels.
A fistula is created by a vascular surgeon and managed by your nephrologist, dialysis center and Interventional physician. We perform angioplasty, declots and stenting of the fistula for maintenance.
In graft-based hemodialysis, a small synthetic tube is implanted under the skin, and connects from an artery into a vein. This tube is used as an access point for needle placement during dialysis. This is essentially a synthetic fistula, and we provide the same services and treatments: angioplasty, declots, and stenting of the fistula for maintenance. Dialysis is still performed and managed through the primary nephrologist and dialysis center.
In peritoneal dialysis, a soft plastic tube (catheter) is placed in the lining of the abdomen (called the peritoneum). Through this catheter, the same cleansing solution used in hemodialysis machines is placed directly into the peritoneum, where it absorbs waste and fluids from the blood and is then drained.
At CiC Salt Lake, we place these catheters. Dialysis is performed and managed through the primary nephrologist and dialysis center.
Dialysis catheter placement
TUNNELED catheter placement is implanting a tube from the surface of the skin to a major vein. The skin helps keep the catheter in place. The catheter has two sections within the tube: a “venous” part that takes the blood from the body to the dialysis machine, and an “artery” part that, once the blood has been filtered and cleaned, returns the blood back to the body.
NON-TUNNELED catheters are typically placed directly into the internal jugular or subclavian vein (in the neck), though occasionally the femoral vein (in the leg) is used. This type of catheter extends outside the skin and can increase risk of infection.
Peritoneal dialysis catheter placementThe peritoneal dialysis catheter is a plastic tube that allows dialysis fluid to enter the belly where it is filtered through the peritoneum. After this process is complete, the fluid is drained from the abdomen.
Dialysis fistula management and de-clot
more information coming soon.