Final answer:
Three ways to gain access to the circulation in hemodialysis include using a central venous catheter, creating an arteriovenous (AV) fistula, or implanting an arteriovenous graft.
Step-by-step explanation:
There are three primary ways to gain access to the circulation in hemodialysis: a central venous catheter, an arteriovenous (AV) fistula, and an arteriovenous graft.
- Central venous catheter - A catheter is inserted into a large vein, typically in the neck, chest, or groin. This is often used for short-term access.
- Arteriovenous (AV) fistula - A surgical connection is made between an artery and a vein, usually in the arm. This preferred long-term access requires several weeks to heal before it can be used for hemodialysis.
- Arteriovenous graft - If the patient's veins are not suitable for a fistula, a graft (a synthetic tube) is implanted under the skin to connect an artery to a vein. This can be used for dialysis within two to three weeks after placement.
In hemodialysis, a dialysis machine removes waste products such as urea, as well as excess water from the blood, before returning the cleaned blood to the patient. This process typically occurs in a hospital or dialysis clinic multiple times per week.