Caring for your dialysis access

caring for your dialysis access?
Living with Dialysis

Daily access checks and infection prevention

Your access is so important that it’s sometimes referred to as your ‘lifeline for a lifetime.’ Proper care of your dialysis access is essential to ensure that it lasts and functions properly. Here are some important tips that may help your access last longer:

  • Check your access every day to make sure it’s healthy.
  • Know the signs of infection and other problems.
  • Carefully follow your care team’s instructions on caring for your access
  • Contact your care team if you have a question or concern about your access.

Check your access every day

Take a minute every day to check your dialysis access. This way, you’ll notice any changes early to find a small problem before it becomes a bigger one. If you notice anything different, call your dialysis care team immediately.

Hemodialysis fistula/graft
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1

Look at the skin on/around the access

  • The skin should be one color and look the same as the surrounding skin.
  • Call the care team if there’s discharge, redness, or unusual swelling.
2

Bring your access close to your ear

  • Listen for the sound of the blood flowing through the access; you should hear a gentle ‘whooshing’ sound. 
  • If the sound changes or you hear no sound, call your care team. 
3

Gently feel your access

  • Make sure it feels the same as the day before.
  • Lightly touch your scar. You should feel a light vibration or buzz (sometimes called the ‘thrill’). 
  • You should also feel the pulse as your heart pushes blood through the access.
  • If the thrill/pulse looks/feels different or is missing, call your care team as soon as possible.

Hemodialysis catheter
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Every day...

Look at your catheter dressing in the mirror.

  • The dressing should be clean and dry.
  • The dressing should cover the exit site (the place where the catheter comes out of your skin).
  • Call your nurse immediately if:
    • The dressing does not cover the exit site OR
    • The dressing is wet or dirty OR
    • There’s blood or pus on the dressing or around the site where the catheter exits.
    • There’s pain and redness of the skin around your catheter.

Feel over the catheter dressing (do not remove the dressing)

  • The dressing should be dry.
  • You should feel no pain in the area under the dressing.

Call your nurse immediately if:

  • The dressing is wet OR
  • You have pain in the area under the dressing OR
  • Things feel different OR
  • You think you may have a fever.

PD catheter
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Every day...

  • Wash your hands before touching your catheter or dressing.
  • Clean the catheter exit site daily.
  • Secure the catheter to your abdomen with one piece of tape. Don’t pull or twist the catheter.
  • Don’t remove scabs/crust.
  • Make sure your transfer set and catheter tubing are clean and dry.

Call your nurse immediately if:

  • You have a have a catheter leak OR
  • You have contamination at the end of the transfer set OR
  • You have signs and symptoms of infection at the catheter site, such as redness, drainage, pain or soreness, or it’s warmer to the touch than the rest of the skin.
daily dialysis fistula check

Daily fistula/graft check

Ken, a Satellite hemodialysis patient, shows you what to look, listen, and feel for when you check your access.

Daily access check Verifique el acceso todos los días
wash access before dialysis

Access hygiene at your center

Annette, a Satellite hemodialysis patient, offers a few quick tips on what to do when you arrive for treatment. 

Watch access center hygiene video
wash dialysis access at home

Access hygiene at home

Annette, a Satellite hemodialysis patient, offers a few quick tips on caring for your access at home.

Watch at home access hygiene video Higiene del acceso en el hogar

Your dialysis access and infections

For people living on dialysis, infection is something to be taken very seriously. There are two main types of infections specifically related to dialysis you should know about: blood stream infection and peritonitis.  If you have any of these symptoms or have questions, contact your care team immediately.

Hemodialysis: Blood stream infection
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Blood stream infection

Blood stream infection is when bacteria or fungi enters your blood. For people on dialysis, it’s often caused through contamination at the hemodialysis access. For example, a small skin infection at the access site can cause the germ to enter the blood, quickly spreading throughout the body. 

If untreated, a blood stream infection can trigger the body to fight germs, but this helpful process can inadvertently cause damage to multiple organ systems. Blood stream infection is the second leading cause of death in people on dialysis.

Symptoms include chills, sweating, shaking, moderate/high fever, weakness, rapid breathing, increased heart rate, and paleness, especially in the face.

Peritoneal dialysis: Peritonitis
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Peritonitis

Peritonitis is the inflammation of the tissue that lines the inner wall of your abdomen. It’s usually caused by infection from bacteria or fungi, often because of accidental contamination through the PD catheter.

If untreated, peritonitis can rapidly spread into the blood and to other organs. Without treatment, it can result in multiple organ failure and even death. 

Symptoms include poor appetite, nausea, and a dull abdominal ache that quickly becomes more severe. Other signs and symptoms include abdominal tenderness, chills, fever, and vomiting.
bubbles

Meet Bubbles, our handwashing champion

Handwashing is an important way to reduce infection risks. Download and post Bubbles' tips on how to reduce the risk of infection by expert handwashing.

nellie

Nellie, the Nephron, shows you how it's done!

This widely popular music video gets your toes tapping all the way to the sink! 

How to keep healthy your…

DO:

  • Wash the skin over your access with soap and water every day. Soap removes the oils on skin that can trap bacteria, which could find its way into your bloodstream if it is not removed.
  • Conduct your daily one-minute access check.
  • Tell your care team if you see a bruise or feel a change in the skin over your access.
  • Rotate needle sites at each treatment.

DON’T:

  • Wear tight-fitting clothing or jewelry that will put pressure on your access arm.
  • Carry heavy objects across the arm (e.g., a purse or briefcase) that will compress the access.
  • Have blood drawn, perform blood pressure checks or have IVs started in your access arm.
  • Scratch or pick at any scabs on your access.
  • Sleep or rest your head on your access arm.

Read more on how to keep your vascular access healthy

DO:

  • Wash your access area with the recommended antibacterial soap or cleanser. Rinse with sterile water or saline.
  • Pat the skin dry with a clean, unused cloth or towel.
  • Apply antibiotic cream around the catheter. Cover with sterile gauze.

DO NOT:

  • Pick or remove crusts or scabs at the exit site.
  • Take a bath or use a hot tub, so as to reduce the risk of infection.
  • Swim in public pools or fresh water rivers/lakes.

DO:

  • Secure the catheter close to the skin. Make sure there are no kinks or bends in the catheter
  • Keep the catheter and dressing clean and dry. Check with the dialysis staff if the dressing becomes wet or very dirty.
  • Notify the dialysis clinic staff or your doctor immediately if there’s any sign of infection, such as fever, chills, redness, swelling, pain, drainage, or heat at the site of the catheter.

DO NOT:

  • Pull on your catheter.
  • Use sharp objects near the catheter (scissors, safety pins, etc.).
  • Remove the dressing between dialysis treatments unless instructed to do so.
  • Open the clamps or caps of the catheter.
  • If the catheter pulls out, do not try to push the catheter back into your body. Call the doctor or dialysis clinic for instructions.

Learn more about your hemodialysis catheter

Have a hemodialysis catheter?

Ask your kidney doctor or care team about a fistula or graft access. Benefits include lower risk of infection and needing hospitalization. Plus, more efficient dialysis may mean less treatment time and more energy!

Read more about access options.

Learn more about the advantage of a fistula or graft.
best dialysis access

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