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Vascular Access

In order to perform hemodialysis, access to the patient’s blood is required. This can be via a dialysis catheter, an ArterioVenous Fistula (AVF), or an ArterioVenous Graft (AVG).

When dialysis has to be started in an emergency situation, a dialysis catheter is used.  Catheters can be used immediately after placement. Catheter placement runs several risks, including injury to neck blood vessels and the lung.

There are two types of dialysis catheters:
  1. Temporary dialysis catheter – can be placed in the neck (preferred) or groin.
    • Placed at bedside (with the use of an ultrasound machine).
    • High risk of infection (ideally should be removed within 1 week).
  2. Tunnelled dialysis catheter – mostly commonly placed in the neck.
    • Can be placed at bedside, but usually placed in the Cardiac Cath Lab or Operating Room (with the use of a C-arm).
    • High risk of infection (but lower risk than a temporary catheter) – can be kept in place for months to years.

For ESRD patients who need chronic ongoing dialysis, permanent vascular access is required. The preferred access is the AVF, followed by the AVG, with the least favored being the tunnelled dialysis catheter (in cases of poor veins).

  1. ArterioVenous Fistula – preferred type of hemodialysis access:
  • Created at the wrist or the elbow.
  • Day-care surgery in the Operating Room.
  • Lowest risk of infection of any type of dialysis access.
  • Requires two needles to be placed for the removal and return of blood.
  • Takes at least 6 weeks to be strong enough for use; some patients may take longer, and for some patients, these do not develop well for use.

   2. ArterioVenous Graft:

  • Created in the upper arm; rarely in the thigh.
  • Day-care surgery in the Operating Room.
  • Higher risk of infection than AVF but lower than catheters.
  • Requires two needles to be placed for the removal and return of blood.
  • Can be used earlier than an AVF.

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What My Patient Says?

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She is available and super active with her patients like as Isaid for me. She treats in a friendly manner and is very very flexible with hee patients. She takes very good care and in every visit of mine she has met me . I got super treatment during dialysis and the transplant happened with very ease and planned way.the outcome is great. Completed one year after that . I had been meeting her in video consultancy last 1 year. Thank you Doc for the support .

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Priyanka Ghoshal

Patient
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we had consulted her for my dad's creatine issue the Dr diagnosed the issue and prescribed good medication in a few weeks the creatine came down. strongly recommend this doctor. Manipal appointment system had some issues, but the doctor was kind enough to help us out of her way and guided us on how to get this appointment faster much, appreciated her efforts in caring for her patients

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Vinay Duby

Patient
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I would have given 10 stars to Dr Pallavi. Both me and my wife have been patients of Dr. Pallavi for more than 6 years now. She supported us throughout—before, during, and after our transplant. Dr. Pallavi has been much more than a doctor to both of us, probably a "health mentor" through all these years. While Dr. is excellent from a clinical standpoint, more impressive is her ability to listen to the patient and engage in a very pleasant and positive conversation to ensure that the (already tense) patient is at ease. I have personally seen her nephrology department grow in the hospital. All the best, Doc.............you are doing a wonderful job.

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Anil

Patient
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We are extremely grateful and blessed to be treated under the Most humble yet very competent and knowledgeable Dr Pallavi Patri at Manipal Sarjapur road. The way you treat your patients is commendable. Your concern and care , cheerful nature, and positive approach to the patient are beyond medicines. We were able to conquer the toughest phase of our life only because you helped us believe there was light on the other side. We want to thank you for being so humble and professional. The Nephro team under Doctor Pallavi is dedicated , committed and ready to help even with minor queries to provide ease to the patients. Dr, you are a true definition of efficiency and hard work. When life came in as a pause and a rude shock, you helped with a restart button ; to move ahead and forward in life with hope. Thank you, dear doctor!

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Puja Sundorson

Patient