Getting the Care You Need
At Lahey Hospital & Medical Center, we offer both hemodialysis and peritoneal dialysis. If dialysis is needed, your provider will explain the differences and help you determine which one would be the best fit for you.
Both types of dialysis require minor surgery before treatment begins to create an access that allows treatment to take place. The nephrology team at Lahey works closely with our transplant and vascular surgeons to plan your procedure.
For hemodialysis, minor surgery is required to create a vascular access so that blood can reach the dialysis machine and be returned after the filtration process has been completed.
There are three types of vascular access:
- Arteriovenous fistula (AVF)—Created by connecting an artery and vein.
- Arteriovenous graft (AVG)—This uses a synthetic tube to connect an artery to a vein.
- Venous catheter—This provides a temporary alternative by inserting a small, soft tube usually into a large vein in your neck. A catheter is typically used if you need to start dialysis before you have a vascular access created.
If your access is an AVF or AVG, the dialysis nurse or technician will place two needles into the access at the beginning of each treatment. These needles connect to tubing that takes blood to and from the dialysis machine.
If a venous catheter is used, the blood is taken directly to and from the catheter and no needles are required.
An AVF is the best type of access because it lasts longer and is less likely to clot or be the source of infection. It can take a fistula three to six months to be ready to use, so your nephrologist will refer you to have this placed when you are getting close to needing dialysis.
We discourage using venous catheters because of the high rate of bloodstream infections associated with them. However, we do use them when they are the only option we have at the time.
For peritoneal dialysis, a peritoneal dialysis catheter (a soft plastic tube) is inserted into your belly. This tube is attached to a bag of the dialysis fluid so it can drain in and out of your abdomen.
The catheter is surgically inserted at least two weeks before you start peritoneal dialysis to allow the catheter site to heal.
Education and Training
If you need dialysis, you probably have questions about what to expect and the steps you should take to prepare for treatment. Our team includes nephrologists, social workers, nurses, nurse practitioners, nutritionists and others committed to educating you about your condition and your options for treatment.
If your treatment plan includes peritoneal dialysis, we offer a training program taught by a registered nurse to make sure you understand each step of the process so you can self-administer your care with confidence.