Access Planning

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Kidney failure means that your kidneys can’t clean your blood of the waste products and the fluid that builds up in your body. When your kidneys start to fail, it may take a few years for them to stop working. Once they stop working, it is called kidney failure.

If you have kidney failure, you will need dialysis or a kidney transplant to stay alive. A kidney transplant is surgery to place a healthy kidney into a person with kidney failure. Most people need to do dialysis while they are checked to see if they can get a transplant. The amount of time you have to wait for a new kidney is different for every person. It depends on a lot of things. Your practitioner or dialysis care team will help you understand what this means for you.

Starting Out: Understanding My Treatment Choices

When you start dialysis, you may have questions about your treatment choices. There are three main types of treatment:

  • Hemodialysis (HD): a type of dialysis done at home or in a clinic;
  • Peritoneal dialysis (PD): another type of dialysis that is done at home; and
  • Kidney transplant: receiving a new kidney from a living or deceased donor. Your dialysis care team can help you learn more about each choice.
If you think peritoneal dialysis is the best for you, you will need to have an access made especially for PD. Talk to your care team about this type of access.

How Do I Choose a Treatment?

It is important for you to review each of your treatment choices. If you have questions about the types of treatments, there are materials you can review.  Talk with your practitioner or dialysis care team to help you decide which is the best choice for you.  En Español

If you think hemodialysis is best for you, you will need to have a vascular access made. You need this so your blood can be cleaned by the dialysis machine.

I Am Going to Do Hemodialysis and Need an Access Plan

If you and your dialysis care team decide that hemodialysis is the best choice for you, you will need to have a vascular access made. This is important because an access is your lifeline for a lifetime. Your dialysis care team will tell you about the types of vascular accesses you can have.  For most people, an AV fistula is the best type of access. You need a vascular access so blod can flow in and out of the dialysis machine.  The dialysis machine will clean your blood of the wastes and fluids that have built up as it moves in and out of the machine.

This guide is meant to help you get started in making a vascular access for hemodialysis. In order to get started, you will need an access plan to help guide you through all the steps toward a fistula or graft. You and your dialysis care team will make this plan together.

The guide lists all the steps in your access plan. You can use this guide to keep track of the access planning steps. After you review all the steps, you should be able to see what step you are on. Some of you may need to start at the beginning and go through all the steps. Some of you may already have an access in place. If you are at Step 8, you should be doing your daily one minute access check. 

Download Complete Guide Descargar La Guía Completa

Making an access plan

Image of a checklist.

Finding the best place for my access

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Going to see the surgeon

Doctor Talking with Young Woman

Going for surgery

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Waiting for my access to mature/heal

Image of an are with a fistula.

Using my access

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Removing my catheter

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The one-minute access check

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