• ​Permanent 
  • Beneath the skin
  • Lasts longest, up to 2 years
  • Provides greater blood flow for better treatment
  • Fewer infections & other complications
  • Fewer hospitalizations 
  • Better survival (lower risk of dying than patients with catheters)


  • May  not mature/develop
  • Not possible for all patients 
  • Usually cannot be used for at least 6-8 weeks

An fistula directly connects an artery to a vein. The vein stretches over time, allowing needles to be put in it. Fistulas are the best way to get access to the bloodstream for hemodialysis. 

Talk with your doctor to decide which type of vascular access is best for you. 

Hemodialysis Vascular Access

Hemodialysis cleans your blood through a fistula, graft or catheter. One of these will be your hemodialysis LIFELINE!


  • ​Permanent 
  • Beneath the skin
  • May be used after 2 weeks, in some cases
  • May work in patients with poor veins


  • Does not last as long as a fistula
  • Increased risk for clotting
  • Increased risk for serious infections
  • Increased risk for other complications and repair procedures 
  • Increased hospitalizations



A catheter is a tube inserted into a vein in the neck or chest to provide vascular access for hemodialysis. This tip rests in your heart. It is usually a temporary access. It is a third choice for getting access to the bloodstream for hemodialysis. For some patients it is the only choice and it will need to be used as a permanent access.


  • Can be used immediately after placement


  • Does not last long, usually less than one year
  • May require longer treatment times
  • Prolonged use may lead to inadequate dialysis
  • Higher infection rates, which can be very serious or fatal
  • Cannot shower without special appliance 
  • High rate of clotting requiring frequent procedures 
  • Risk of destroying important veins
  • ​Increased hospitalizations 

A graft is a tube, usually made of plastic, that connects an artery to a vein. Grafts are the second best way to get access to the bloodstream for hemodialysis. 

Blessios Medical, PLLC