Dialysis access
Formal Definition
The vascular or peritoneal access point through which hemodialysis or peritoneal dialysis is performed; includes arteriovenous fistulas (AVF), arteriovenous grafts (AVG), tunneled dialysis catheters (TDC), and non-tunneled temporary catheters (e.g., Quinton catheter).
How It's Used on the Ward
"Access" or "fistula" — on the wards, knowing a patient has dialysis access means hemodialysis is imminent or ongoing; "access is down" is an emergency.
Example
""She's ESRD on three-times-weekly HD. Fistula is in the left forearm — do NOT use that arm for blood draws, BPs, or IVs. Access team aware she missed last session; potassium is 6.1, dialysis coming in 2 hours.""
Clinical Context
Protect the fistula arm: no blood draws, no IVs, no BP measurements — a blown fistula can take months to mature again or require surgery. Tunneled dialysis catheters (Hickman-style, internal jugular) are reserved for patients awaiting fistula maturation or with failed access. Temporary non-tunneled catheters (femoral or IJ) are for acute urgent HD only — infection risk is high. Peritoneal dialysis uses the peritoneal membrane — patients can often do this at home.