If your kidneys fail, unless and until you have a successful kidney transplant, you will need dialysis therapy to clean and filter your blood. The first step is establishing dialysis access one of four ways:
1. A tunneled catheter in your neck—temporary, because the possibility of infection is high.
2. An AV fistula—taking a piece of a vein from your arm or leg and sewing it into a nearby artery, and allowing the sewn-in vein to enlarge and become thicker, like an artery. Considered the best option because it has the lowest risk of infection.
3. An AV graft—the sewing of a prosthetic graft between an artery and vein in your arm or leg. The preferred option if your veins are too small for an AV fistula. AV grafts tend to close more quickly and are more prone to infection because they are not formed from natural tissue.
4. Peritoneal dialysis—placement of a small tube, called a cannula, in your abdomen to allow the use of the lining of the abdomen (peritoneum) to filter your blood. It requires several “exchanges” every day: you introduce and remove fluid through the tube. A convenient option because you perform the dialysis therapy at home, but infections sometimes occur and the tube can become clogged.