Kidneys and Your Vascular Health

Your kidneys remove excess water and waste products from your body.  When the kidneys start to lose function, it is most commonly due to advancing age, long-term effects of high blood pressure, diabetes, heart issues, or a combination of these factors.  Sometimes, infections and diseases that are present from birth can affect kidney function.

Because we have two kidneys, mild loss in the function of one kidney can be compensated by the other one.  However, when both kidneys start to fail, you have to be started on dialysis with the help of a nephrologist, or kidney doctor.  Dialysis replaces some of these functions when your kidneys no longer work. There are two different types of dialysis — hemodialysis and peritoneal dialysis. 

Hemodialysis is a procedure in which a dialysis machine and a special filter called an artificial kidney, or a dialyzer, are used to clean your blood. To get your blood into the dialyzer, a vascular surgeon needs to make an access, or entrance, into your blood vessels. This is done with minor surgery, usually to your arm.

What is an arteriovenous fistula?

An AV fistula is a connection, made by a vascular surgeon, of an artery to a vein. Arteries carry blood from the heart to the body, while veins carry blood from the body back to the heart. Vascular surgeons specialize in blood vessel surgery. The surgeon usually places an AV fistula in the forearm or upper arm. An AV fistula causes extra pressure and extra blood to flow into the vein, making it grow large and strong. The larger vein provides easy, reliable access to blood vessels. Without this kind of access, regular hemodialysis sessions would not be possible. Untreated veins cannot withstand repeated needle insertions because they would collapse the way a straw collapses under strong suction.

Health care providers recommend an AV fistula over the other types because it provides good blood flow for dialysis, lasts longer than other types of access, and is less likely to get infected or cause blood clots than other types of access.

This column is sponsored by KSC Cardiology, and the opinions expressed herein may not reflect those of CFHN or its advertisers.

BIO: Dr. Aparajita is a fellowship-trained vascular and endovascular surgeon. She is a co-author of 20-plus journal articles and publications and was recently nominated for an Inspiration Award by the American Medical Association.