Learning About Vein Preservation When You Have Chronic Kidney Disease

When you have chronic kidney disease, your kidneys don't work as well as they should. Some people who have chronic kidney disease may eventually need hemodialysis. This is a way to clean your blood when your kidneys can't.

Before you can start hemodialysis, a doctor must first create a place where blood can flow in and out of your body during the dialysis sessions. This is called a dialysis access. The access is made during a surgery in which the doctor connects a vein and an artery in the arm. Healthy veins are important for this procedure.

Taking good care of your veins now will help your doctor create a healthy dialysis access if you need it.

If you are already receiving hemodialysis, caring for your veins can help protect the access and keep it working well.

Blood draws or intravenous (I.V.) lines that use the veins in your arms can damage those veins. Over time, this can cause your veins to become scarred. Scarring makes it harder to use those veins to create a dialysis access.

• Tell all health care providers that you have chronic kidney disease and that you are protecting the veins in your arms. Your doctor may give you a wallet card or wristband that explains this.
• Ask for blood draws or I.V.s to be done using the veins on the back of your hand. Avoid using the veins in your arms as much as possible.
• Ask your health care provider to use the smallest needle possible when you have a blood draw or an I.V.
• If you have frequent blood draws, ask to alternate which veins are used.
• Talk with your doctor about which arm they would use if they needed to create a dialysis access. Your doctor may suggest protecting the veins in that arm by only using your other arm for blood draws and I.V.s.
• Avoid peripherally inserted central catheter (PICC) lines if possible. A PICC line is a type of I.V. that may be used for long-term I.V. medicine. If you need long-term I.V. medicine, ask your doctor about other options.
• If you already have a dialysis access in your arm:
  • Don’t use that arm for blood draws, I.V. lines, or PICC lines.
  • Ask to have blood pressure checked using the arm that doesn't have the access.
  • Continue to protect the veins in the arm that doesn’t have the access as much as possible.