Placement of Peritoneal and Hemodialysis Access
For patients who need routine dialysis, OHSU Vascular Surgery can place the access site with surgical precision.
Peritoneal dialysis is performed by surgically placing a special, soft, hollow tube into the lower abdomen near the navel. After the tube is placed, a special solution called dialysate is instilled into the peritoneal cavity. The peritoneal cavity is the space in the abdomen that houses the organs and is lined by two special membrane layers called the peritoneum. The dialysate is left in the abdomen for a designated period of time which will be determined by your physician. The dialysate fluid absorbs the waste products and toxins through the peritoneum. The fluid is then drained from the abdomen, measured, and discarded.
Hemodialysis can be performed at home or in a dialysis center or hospital by trained healthcare professionals. A special type of access, called an arteriovenous (AV) fistula, is placed surgically, usually in your arm. This involves joining an artery and a vein together. An external, central, intravenous (IV) catheter may also be inserted, but is less common for long-term dialysis. After access has been established, you will be connected to a large hemodialysis machine that drains the blood, bathes it in a special dialysate solution which removes waste substances and fluid, then returns it to your bloodstream.