The dialysis shunt is used to keep a connection for the dialysis cannulas open for kidney patients. At the same time, it also ensures sufficient blood flow: blood flows of 200 to 500 ml of blood per minute are required for dialysis. A punctured vein, such as the one used for blood collection, is far from sufficient for this.
Below you will find further information and specialists for the installation of a dialysis shunt.
Patients with end-stage renal disease can no longer cleanse their blood of harmful substances on their own. This vital function of the kidney must therefore be regularly replaced by medically supervised blood washing(dialysis).
For dialysis, patients need a permanent access point to the bloodstream: The so-called dialysis shunt. This is a short-circuit connection between an artery and a vein.
The aim is to have easy access to the bloodstream to which the dialysis machine can be connected. This permanent vascular connection is also the main risk of complications.
A dialysis shunt serves as easy access to the bloodstream © ひろみ きたはし | AdobeStock
As a rule, both arms are equally suitable for placing a dialysis shunt. However, it has proven to be best to use the left arm for right-handed patients and vice versa for left-handed patients. If possible, the doctors place a forearm shunt, the so-called Cimino shunt.
It is not possible to insert a dialysis shunt in people with heart failure, as the strain on the heart is too great.
The puncture of the dialysis shunt is usually somewhat painful for dialysis patients at first. The pain fibers responsible for this recede over time due to the repeated punctures in the shunt area. The pain is therefore reduced.
If it is not possible to insert a dialysis shunt in the lower or upper arm, specialists can also use an atrial catheter. However, this results in a significantly lower blood flow. Peritoneal dialysis is also possible.
In addition to permanent dialysis, however, kidney transplantation is the best option for the patient. This restores natural blood purification with the help of the kidneys. Dialysis is then no longer necessary.
Unfortunately, however, there is a shortage of donor organs and the search for a suitable donor is usually very lengthy. This is why dialysis is the only available option for many patients with end-stage renal disease in the long term.
The short circuit between the arterial and venous blood flow is not actually a natural condition. Therefore, over the course of a dialysis shunt's lifetime, it often slowly closes and may even be lost.
The following complications can occur with a dialysis shunt
A shunt infection can cause an undetected shunt occlusion. You should therefore consult a doctor immediately if you experience the following symptoms:
Many of the aforementioned complications with dialysis shunts are due to the fact that this vascular short circuit is created. It is therefore particularly important to ensure close follow-up of patients. This is the only way to recognize and treat problems at an early stage.
Hematomas and injuries can be avoided by preventing incorrect punctures. The risk of infection also correlates with the hygiene measures applied. The stricter the hygiene is maintained, the less concern there is with regard to the risk of infection when a dialysis shunt is inserted.
In general, shunt aftercare in particular should be in the hands of experienced doctors. This is the only way to prevent harm to the patient.
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