Dialysis Access


When kidney failure or end stage renal disease develops, patients require dialysis to replace the work of the kidneys by cleaning the blood of waste products. Dialysis is frequently performed by direct cleansing of the blood, known as hemodialysis; a process where blood is removed from the body and passed through a machine called a dialyzer. The clean blood is then pumped back into the blood stream. Hemodialysis is usually done every other day.

A second option for dialysis is peritoneal, a process where fluid, known as diasylate, is instilled into the abdomen. This special fluid acts to draw out waste products and excess water from blood vessels that run through the abdomen. The fluid is then drained out of the tube and disposed. This is done on a daily basis.

To allow for hemodialysis, many patients initially require a dialysis catheter, a tube that is placed into one of the large veins in the chest. This is usually a short term option for dialysis access. The longer term access for dialysis requires a fistula or a graft. This is a connection between an  artery and a vein using the patient’s own vein or a synthetic tube graft usually in the arm. These forms of access allow for blood to be withdrawn from the body and run through the dialysis.

For peritoneal dialysis, tubing must be placed surgically into the abdominal cavity so the fluid for dialysis can be instilled.

ELLIPSYS/Non-Surgical Fistula


A new, minimally invasive, groundbreaking, effective method to create a “non-surgical” percutaneous arteriovenous (AV) fistula for hemodialysis access in patients has recently been developed.  It’s called ELLIPSYS.  This method enables vascular surgeons to puncture an artery and vein, using a small IV in the forearm, to create a fistula.  A fistula is a connection between a vein and artery that’s used as the access point for dialysis treatment.  Not all patients will be candidates for this technique.  We determine whether it’s an option with a simple in-office test.

Dr. Bafford and an Ellipsys patient discuss their experience with this groundbreaking technology and the benefits of the minimally invasive procedure, including less pain, shorter recovery time and greater patient satisfaction.