Safer Dialysis Access

October 9, 2014 by Vascular Experts

Millions of Americans suffering from chronic kidney disease are treated with a process called Renal Dialysis. The process requires the patient to be connected to a machine for up to four hours while the blood in the body is cleaned by the machine and returned to the body.The human kidney is responsible for filtering the blood of unnecessary toxins, maintaining proper electrolyte balance, and regulating blood pressure. Chronic kidney failure can result from diseases such as hypertension, diabetes, atherosclerosis, familial genetic disorders, auto immune disease, or even from regular use of some medications. Until a patient can receive a transplant, renal dialysis is the intervening process by which the blood is filtered in the absence of fully functional kidneys.


Easier Dialysis Access through a Vascular Fistula

At the The Vascular Experts, we aim to make dialysis easier and safer. We can create a fistula* by connecting a vein to an artery. This is a minor outpatient procedure done at a hospital or an outpatient surgery center.  After completion it can take up to three months for a fistula to be large enough to be used for dialysis.  We work closely with nephrologists to select the best time to start using a fistula.

The fistula can be accessed many times to perform hemodialysis treatments. We assess the fistula every two to three months with a non-invasive ultrasound exam in our office. If there are any signs of damage, we repair the fistula with minimally invasive techniques such as angioplasty and stenting in our outpatient procedure suite.

The National Kidney Foundation (NKF) and other medical organizations agree that fistulas are the best type of vascular access for many reasons, including:

  • Lower tendency to clotting
  • Lower risk of infection
  • Greater blood flow
  • Reduced treatment time

A vascular fistula can stay functional far longer than other dialysis access types, giving the dialysis patient much relief.


Tips to Keep Blood Flowing Easily Around Dialysis Access Area

  • Avoid tight clothing or jewelry that can put pressure on the access area
  • Avoid carrying heavy bags, purses, or other items over your access area
  • Avoid having your blood pressure taken on your access arm – use the other arm
  • Don’t sleep with your access arm under your head or a pillow, anything that could add pressure

For many dialysis patients, a fistula has made the dialysis process easier and safer and who better to create a fistula than a vein specialist? At The Vascular Experts, our goal is to deliver the best possible patient experience through real, lasting results for patients with kidney failure.

*A fistula is a passageway between two organs in the body or between an organ and the exterior of the body. When created surgically, it is one to achieve therapeutic purposes or obtain body secretions for physiologic studies. An arteriovenous fistula (connecting a vein to an artery) is commonly created to gain access to the patient’s bloodstream for hemodialysis.


Jonathan N. Bowman, MD, FACS

Jonathan N. Bowman, MD, FACS, is a board certified general and vascular surgeon at The Vascular Experts, where he uses his expert experience in the treatment of peripheral arterial disease, abdominal and thoracic aortic aneurysms, acute and chronic deep vein thrombosis, carotid artery disease, hemodialysis access, and varicose veins. His particular area of interest is minimally invasive endovascular techniques.

Dr. Bowman received his medical degree from The University of Virginia School of Medicine. He then completed his internship and residency in general surgery at the University of Texas Health Science Center at San Antonio and Wilford Hall Medical Center. Dr. Bowman is a Fellow of the American College of Surgeons and is an active member of the Society of Vascular Surgery.

Please contact Dr. Bowman at with any additional questions.