Dialysis Access Procedures

Dialysis is a treatment for severe kidney failure (also called renal failure, stage 5 chronic kidney disease, and end-stage renal disease). When the kidneys are no longer working effectively, waste products and fluid build up in the blood. Dialysis take over a portion of the function of the failing kidneys to remove the fluid and waste.

Dialysis is typically needed when about 90 percent or more of kidney function is lost. This usually takes many months or years after kidney disease is first discovered. Early in the course of kidney disease, other treatments are used to help preserve kidney function and delay the need for replacement therapy.


Once dialysis becomes necessary, you (along with your physicians) should consider the advantages and disadvantages of the two types of dialysis:

  • Hemodialysis (in-center or at home)
  • Peritoneal dialysis

The choice between hemodialysis and peritoneal dialysis is influenced by a number of issues such as availability, convenience, underlying medical problems, home situation, and age. This choice is best made by discussing the risks and benefits of each type of dialysis with a healthcare provider.



Before peritoneal dialysis can begin, a catheter (thin tube) must be inserted in the abdomen to carry fluid into and out of the abdominal cavity. The catheter is made of a soft, flexible material (usually silicone) and has cuffs (like balloons) that inflate to hold the catheter in place. The end of the catheter inside the abdomen has multiple holes to allow fluid to flow in and out.

The catheter is placed on the left or right of the umbilicus (belly button); the patient may be given general or local anesthesia before the insertion procedure.

Although the catheter can be used right away, it is best to wait 10 to 14 days after placement before dialysis is performed; this allows the catheter site to heal. In some cases, a small volume of fluid can be exchanged during this time