Dialysis Access Services

Dialysis is a life-saving treatment that cleans and filters your blood if you have end-stage kidney disease and your kidneys aren’t working properly. Dialysis access is a surgical procedure to create a direct pathway to your bloodstream for your dialysis treatment.

UPMC is a leading health system in the U.S. and the only one that offers a dedicated Dialysis Access Center. We specialize in creating access points for dialysis treatment using the latest techniques.

What Is Dialysis? 

Dialysis — or renal replacement therapy — is a treatment for people with end-stage kidney disease. It involves cleaning and filtering waste from the blood, doing the job of the kidneys when they no longer work properly.

If your kidneys can't filter waste from your blood, fluid and toxins can build up in your body. This build-up can lead to serious health problems and, over time, death.

Dialysis will do everything your kidneys used to do, including:

• Help control your blood pressure.
• Manage your electrolytes.
• Remove extra fluid from your blood.
• Remove toxins from your body that your kidneys used to remove.

Types of dialysis

There are two common types of dialysis:

• Hemodialysis — Performed using a machine at a dialysis clinic or home three times a week for four hours. This is the most common form of dialysis in the U.S.
• Peritoneal dialysis — Performed through a catheter in your abdomen at home. It can be performed by hand several times a day or using a machine overnight while you sleep.

What Are Dialysis Access Services?

Dialysis access — also known as vascular access surgery — creates a way for your blood to flow out of your body to the dialysis machine and back again during hemodialysis. If you choose to have peritoneal dialysis, dialysis access surgery involves placing a catheter into your abdomen.

You will need to have a minor surgical procedure to create a pathway to your bloodstream a few weeks or months before you plan to start dialysis.

What Conditions Do We Treat? 

Dialysis can be used to treat:

• Acute kidney injury.
• Chronic kidney disease (CKD) (stage 5)
• End-stage kidney disease.

Who’s Eligible for Dialysis Access Services?

If you have end-stage kidney disease and are planning to start dialysis, you may be eligible for dialysis access services.

What Dialysis Access Services Do We Offer? 

We offer a full range of dialysis access services, including:

• Catheter placement and exchange.
• Dialysis access education.
• Dialysis access placement, revision, and replacement.
• Surgery to remove a blood clot from a blood vessel (thrombectomy).
• Vein mapping and venous duplex.
• X-rays to look at the blood flow and check for blood clots or other blockages in your fistula.

Dialysis access procedures

Hemodialysis vascular access surgery

Vascular access surgery creates a way for your blood to flow out of your body to the dialysis machine and back again.

Types of vascular access procedures include:

• Arteriovenous (AV) fistula — A few months before you start dialysis, your surgeon will connect an artery, which carries blood away from your heart, and a vein, which carries blood to your heart, under the skin in your arm.
• AV graft — A few weeks before you plan to start dialysis, your surgeon will connect an artery and vein under the skin in your arm using a plastic tube.
• Venous catheter — Your surgeon will connect a Y-shaped tube called a catheter to a vein in your neck, chest, or leg. Catheters are usually used for temporary access when you need to start dialysis quickly.

Peritoneal dialysis catheter placement

Peritoneal dialysis catheter dialysis placement creates a way for you to fill and drain dialysis fluid from your abdominal cavity — a process called an “exchange” — during your peritoneal dialysis treatments.

Ongoing dialysis access care

Our team provides dialysis access follow-up care for people who need:

• A new peritoneal dialysis catheter.
• Dialysis access revision or replacement.
• Imaging to diagnose a blockage or another problem with their dialysis access.
• Routine exams of their dialysis access site.
• Surgery to remove a blood clot from a blood vessel.

What Can I Expect? 

If needed, your dialysis access expert will work closely with your kidney doctor and dialysis center to schedule your procedure and avoid treatment delays.

Your dialysis access care will depend on whether you are planning to have hemodialysis or peritoneal dialysis. If you are having hemodialysis, the type of procedure you have will depend on which type of vascular access your doctor recommends.

During your first appointment at the UPMC Dialysis Access Center, your doctor will:

• Ask questions about the type of dialysis you plan to have and your care goals.
• Order tests, such as vein mapping and venous duplex ultrasound, if needed before your procedure.
• Perform a physical exam.
• Provide education about dialysis access.
• Review your treatment and health history.

After your visit, your doctor will schedule a time for you to have your dialysis access procedure. After your procedure, your doctor will tell you when to return for follow-up care and how soon you can begin dialysis treatment.

Why Choose UPMC for Dialysis Access Services? 

When you choose UPMC for dialysis access services, you will receive:

• Access to world-class nephrology expertise — Our world-renowned experts treat the full spectrum of kidney diseases using the latest diagnostic and treatment techniques.
• A full range of treatment options — We'll work with you to develop a treatment plan that slows the progression of your disease as much as possible and improves your quality of life.
• Multidisciplinary care — We partner with special dialysis clinics, experts in supportive care, and kidney transplant surgeons to ensure you receive complete care.

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By UPMC Editorial Staff. Last reviewed on 2025-04-24.