Kidney (Renal)

Types of Dialysis Access Points

An access point is necessary for our patients to safely receive dialysis. The type to be used – catheter, fistula or graft – is chosen based on the child’s specific situation. 

A catheter is a small tube that helps your child’s dialysis start right away.

•  For our patients to have safe and easy access for hemodialysis treatments, the catheter is gently placed under the skin into a vein, usually in the chest or neck. 
• For children undergoing peritoneal dialysis, a different type of catheter is placed in the stomach. This lets dialysis happen at home while the child sleeps, helping them stay comfortable and maintain their daily routine.
• Your child can take baths or showers, but the catheter and all its connections must be kept covered and dry. Follow these important water safety steps:
  • During a bath, a child should never be fully submerged under water. 
  • Swimming is not allowed with a central line due to the increase the risk of infection. 

A fistula is a long-term access option for a dialysis patient. 

• Unlike a catheter, it does not give immediate access, but it’s designed to be a strong and reliable “super vein” for the child’s treatments. It’s created during a surgical procedure that connects a vein and an artery, allowing dialysis to be done safely over the long term.
• Once the fistula is fully healed, any temporary access (such as a catheter) can be removed. A healed fistula gives our patients more freedom to swim, take showers or baths fully submerged and participate in many physical activities.

A graft is similar to a fistula, but instead of using the child’s own vein, a special synthetic tube is used to connect an artery and a vein. This creates a strong “super vein” that can be used for dialysis.

• Grafts are usually recommended when the child’s veins are too small or need extra support to handle dialysis treatments safely. Like a fistula, a graft is a long-term access option that helps the child stay active and healthy, while giving them more freedom once it’s fully healed.

How to maintain the child’s access point

With each access type, aspects of hygiene and bathing are extremely important. Caregivers and patients should always wash their hands thoroughly with soap and water before touching the dialysis access.

Keep the dressing over the access clean and dry. If it gets wet, let the dialysis unit know right away.

For hemodialysis patients, dressing changes will happen at the dialysis unit with our trained staff. For children doing peritoneal dialysis at home, caregivers will be trained to safely change dressings in the home environment.