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Renal Replacement Therapy Access

Renal replacement therapy replaces kidney function in people with kidney failure. While nephrologists (kidney specialists) oversee your care, vascular surgeons place the dialysis port or other access.

At the Washington University and Barnes-Jewish Heart & Vascular Center, vascular surgeons perform procedures to provide dialysis access. Our expert surgeons work hand in hand with you and the rest of your kidney care team to maintain your access and safeguard your health.

Renal Replacement Therapy Access: Why Choose Barnes-Jewish Hospital?

Our surgeons perform advanced procedures to provide all types of dialysis access. We emphasize options that protect and maintain your access.

The Heart & Vascular Center offers:

  • Surgical expertise: We are regional leaders in vascular surgery. Thanks to our affiliation with Washington University, you receive care from a team that uses the latest methods.
  • Open and minimally invasive options: We provide all available types of dialysis ports, including open surgery (using an incision) and minimally invasive (endovascular) approaches.
  • Team approach: We work closely with your nephrologist (kidney specialist) and dialysis center to manage your access. We stand ready to reevaluate and improve access over time as needed. Learn more about nephrology at Barnes-Jewish Hospital.
  • Personal care: We understand the needs of people receiving dialysis. We realize the difference that providing and maintaining access can make in your health and quality of life. Learn more about the expertise of our vascular surgery program.
  • Full spectrum of renal care: Renal replacement therapy is just one part of treatment for end-stage renal disease. Barnes-Jewish Hospital offers care for all phases of kidney failure, including kidney transplantation.

What Is Renal Replacement Therapy?

Renal replacement therapy (RRT), or kidney dialysis, is a treatment for end-stage renal disease. RRT replaces kidney function when your kidneys do not work. Several available techniques filter your blood (hemofiltration) to remove waste and impurities. We offer dialysis at the Washington University Dialysis Center.

Your surgeons and nephrology team collaborate with you to recommend the best dialysis access technique for you. The technique depends on several factors. We evaluate your needs based on the type of kidney failure you have, if you’ve had previous dialysis ports and your treatment preferences. Over time, most patients need to have their access replaced.

Access Procedures for Renal Replacement Therapy 

Our vascular surgeons perform several types of procedures to enable you to receive long-term renal replacement therapy. Whenever possible, we use newer endovascular techniques to create dialysis access. These procedures use minimally invasive approaches instead of open surgery.

Dialysis access procedures we offer include:

  • Arteriovenous (AV) fistula placement: To deliver hemodialysis, we create an AV fistula, usually in your upper nondominant arm. An AV fistula links an artery to a vein so you can receive dialysis using two needles. This approach offers good access with a lower risk of complications. An AV fistula takes about six weeks to heal before you can use it for dialysis. 
  • AV graft placement: An AV graft uses a donated vein or special tubing to connect an artery to a vein. Grafts heal quickly and can be placed in your arm or thigh.
  • Peritoneal dialysis access: Peritoneal dialysis enables you to have dialysis at home. Your surgeon places a soft silicone or polyurethane catheter (tube) into your peritoneal cavity, the space around your abdominal organs. 
  • Venous catheter placement: A venous catheter offers immediate access for dialysis. It is a short-term solution for emergency use or while another form of access heals. You can also use this type of dialysis access if your fistula or graft is having problems. A surgeon places a venous catheter in your chest, typically near your collarbone. 

Our Renal Replacement Therapy Access Team

At the Heart & Vascular Center, you’ll find a close partnership among the many specialists who provide and manage your renal replacement therapy access. Find a doctor.

Your care team may include:

  • vascular surgeons who perform dialysis access and minimally invasive, catheter-based procedures
  • interventional vascular surgeons and interventional radiologists who perform minimally invasive, catheter-based procedures
  • nephrologists, specialists who treat kidney failure and other kidney (renal) conditions
  • psychiatrists and social workers who support you through the emotional and logistical challenges of renal replacement therapy

Renal Replacement Therapy Access Research and Clinical Trials

Thanks to our affiliation with Washington University School of Medicine, our physicians participate in numerous clinical trials to improve patient care. We work to develop new, more effective approaches to renal replacement therapy. Learn more about our innovation.

Contact Us

To make an appointment with a Washington University vascular specialist at Barnes-Jewish Hospital, call 314-273-7373.