Before Dialysis Begins: Why Access Surgery Is Your Most Important First Step

Starting dialysis isn’t something anyone looks forward to, but being prepared makes all the difference when that moment comes. One of the most important steps is making sure you have reliable, long-lasting dialysis access in place.

At Dakota Vascular, we help patients across the Midwest take that first step with confidence.

Whether you’re in the later stages of kidney disease or preparing to begin hemodialysis, dialysis access surgery is the foundation of your treatment. It’s not just about getting the procedure done, it’s about doing it right, with long-term care and support.

We specialize in two primary types of access:

1. AV Fistula – Often the preferred option, a fistula connects an artery directly to a vein, creating a strong, natural access site. It typically takes several months to mature but offers excellent long-term function.
2. AV Graft – A graft uses a soft synthetic tube to connect the artery and vein for patients whose veins aren’t suitable for a fistula. It can be used faster if time is short. Typically AF Graft does not last as long, which is why AF Fistula is ofter preferred if it is an option.

Our team walks you through every option and guides you on when to schedule surgery because timing matters. Planning gives you time to heal and mature, which helps avoid treatment delays and complications.

And we don’t stop after surgery.

Our complete Dialysis Access Care program includes:

• Ultrasound monitoring and diagnostics
• Urgent interventions to keep your access functioning
• Education and prevention strategies to help avoid future issues
• We’re in this with you, not just for the surgery, but for the journey.

A few things every dialysis patient should know:

• Plan early. Don’t wait for symptoms to escalate—dialysis access works best when prepared in advance.

• Be sure to consult with your local Nephrologist to determine when and what access is right for you.

• Protect your arm. Once an access is placed, avoid IVs, blood draws, or blood pressure cuffs on that arm.

• Keep an eye on changes. If your access site looks swollen or red or stops working properly, call us immediately.

• Ask questions. You deserve to feel confident in your care. Our team is here to answer anything—no judgment, no rush.

Dialysis access surgery is about more than vessels and veins. It’s about giving you freedom, reliability, and peace of mind in a season of change. That’s what we do every day at Dakota Vascular.