In-Center
Hemodialysis:
A Place to Feel Better 

All dialysis treatments can be safe and effective. What’s really important is exploring all of your options and choosing a treatment type you’re comfortable with. In-center dialysis offers the reassurance of staff-assisted treatment, labs and checkups all in one place—in the company of others going through the same thing. To make an informed decision on what’s right for you, explore all of the dialysis options.

CHOOSE THE RIGHT TREATMENT FOR YOU 

Whether you’re getting ready for dialysis or want to switch to a different type of dialysis, our Treatment Decision Guide can help you decide what treatment options might be best for you.
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Hemodialysis Access: Your Lifeline for Treatment

During hemodialysis, your access site is your lifeline—it allows blood to safely leave your body, travel to the artificial kidney or dialyzer and safely return to your body. 
There are 3 types of dialysis access sites: fistula, graft or catheter. Depending on your health, the strength of your veins and other factors, you and your doctor can decide which type is best for you.

Be aware that you will need to schedule your surgery for fistulas or grafts in advance of your dialysis treatments. These are considered minor surgeries and are usually done on an outpatient basis. If you have already started your treatment and have a catheter, it is still important to have surgery for a fistula or graft. Catheters are generally not recommended for the long-term because they provide a slower rate of blood flow and have a higher risk of infection and blood clots.

3 types of dialysis access sites

Fistula

  • A fistula is considered the best choice for hemodialysis. It is made with your own blood vessels, provides optimal blood flow and has the lowest chance of infection.
  • To create a fistula, a surgeon connects one of your arteries to a vein under the skin of your upper or lower arm. 
  • If possible, the fistula access should be placed at least 2 to 3 months before you begin dialysis to allow time for it to develop and mature. However, your doctor will recommend appropriate timing.
  • If you are unable to have surgery for a fistula before you begin treatment, it is still possible to do so after your treatment has begun. It is especially recommended if you have had to opt for a temporary catheter.
  • During treatment, a nurse places 2 needles into the fistula. These needles are connected to tubing that lead to and from the dialysis machine. During dialysis, your blood flows out of your body through one needle that is connected to your artery and into the dialysis machine. After your blood is filtered, it returns to your body through the other needle, which is connected to your vein.

Fresenius Hemodialysis Center

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Graft

  • A surgeon connects your artery to a piece of soft tubing that acts like a vein. It’s placed under the skin of your upper or lower arm.
  • During treatment, a nurse places 2 needles into the graft. These needles are connected to the tubing that lead to and from the dialysis machine. During dialysis, your blood flows out of your body through one needle connected to your artery and into the dialysis machine. After your blood is filtered, it returns to your body through the other needle, which is connected to your vein. 

Catheter

  • Most catheters are temporary and used only until a fistula or graft is ready.
  • If your blood vessels are not strong enough for a fistula or graft, you may be a candidate for a catheter.
  • Catheter access is inserted by a kidney doctor (nephrologist) or surgeon.
  • A long Y-shaped tube (catheter) is placed in your neck, chest or groin and is connected to a central vein. The other end of the tubing exits your skin and attaches to the tubing on the dialysis machine.
  • A catheter can be used immediately after placement. 
  • Since catheters have a higher risk of clotting and infection and provide a slower blood-flow rate, they are not recommended for the long-term. If you have a catheter, talk to your doctor to see if you are a candidate for a fistula or graft.