After Dialysis Access Surgery
What to expect as you move forward
Precautions, Self-Care and Dietary Advice to Get You Ready for Treatment
Once you’ve had dialysis access surgery, your dialysis treatment won’t be far behind. Taking good care of yourself during this time is vital. We’re here to guide you.
Your dialysis access team has made sure you’re prepared to leave the hospital. But we’re always available to answer your questions and address any concerns you have. Whether you’re wondering about what to watch for when you return home, what you can and can’t do, or what you should be eating, we've got you covered.
What to Expect
The exact steps you need to take to protect yourself and stay healthy depend on whether you’ve had hemodialysis access surgery or peritoneal dialysis access surgery. In general, though, there’s advice that applies to everyone.
It's normal to experience some pain and swelling after surgery. For the first few days, keep your arm elevated on pillows whenever possible. Keeping your arm above the level of your heart can help control swelling and ease any discomfort you may be feeling.
Your arm may bruise slightly. It’s normal to see some blood oozing through your dressing. But if blood is soaking the dressing or if you see thick, yellow drainage on the dressing, please contact your dialysis access nurse coordinator.
You can expect to feel a "buzzing" sensation through your bandages. The buzzing is normal and means that blood is flowing through the access. This sensation will increase in the days after surgery.
You should be able to move your hand normally and the appearance and general feeling of your hand on the access side should be normal. Your sense of touch in your hand should be normal as well. If you can’t move your hand or feel things in your hand, please contact your dialysis access nurse coordinator. You should also contact your coordinator if your hand becomes pale or blue or turns cold.
Considerations After Dialysis Access Surgery
Managing pain after your surgery is important. Your doctor will discharge you with a prescription for pain medication. Please take it as directed. The medicine should ease the soreness at your access site, although you can expect to feel some discomfort for several days after surgery. If pain at the site becomes severe or doesn’t get better when you take your medicine, please contact your dialysis access nurse coordinator.
Pain medication may cause constipation. So, talk with your doctor about whether you need to take a stool softener or mild laxative.
We recommend that you don’t take prescription pain medication for longer than three days.
If you feel you need help controlling your pain for longer than that, please contact your dialysis access nurse coordinator. If you were taking blood thinners such as aspirin or warfarin (Coumadin) before surgery, please talk with your doctor about when to resume this medication. You should go back to taking any other medicines you were on before surgery.
Herbal Supplements
Please speak with your nutritionist or physician before taking any herbal supplements. Supplements may have potential harmful side effects and be unsafe.
Depending on what kind of dialysis access surgery you’ve had, you’ll have a single dressing or two dressings, and possibly an incision that needs to heal before dialysis can begin. Good incision care and properly managing your dressings can help prevent infection. Closely monitor any changes. If you have questions or concerns, please call your dialysis access nurse coordinator.
It takes time to regain your strength and endurance after dialysis access surgery. Eventually though, your activity level should get back to normal. Activity guidelines and restrictions for the short and long term depend on the type of access surgery you’ve had.
Be sure to consult with your dialysis access team before starting a new exercise regimen. It’s important to make sure it’s safe.
Healthy eating habits before and after your dialysis access surgery can make a big difference in your long-term health. In fact, making good food choices is a good idea not only for you as a dialysis patient, but also for everyone in your family. Our nutrition experts are here to help.
If you haven’t yet started dialysis, you should speak with our nutritionist about any dietary restrictions you should follow. These restrictions are based on your glomerular filtration rate (GFR), a measure of your kidney disease. Our nutritionist is happy to answer any dietary questions.
Eat Three Meals a Day
Be sure to include protein in every meal. Good protein sources include poultry (chicken and turkey), fish and seafood, red meats and yogurt. Although high in cholesterol, eggs, nuts and dairy products such as milk and cheese are also good sources of protein.
Consider Taking a Multivitamin
A multivitamin can help you meet your vitamin and mineral needs if your appetite is poor or if you are not eating a balanced diet. But check with your doctor to make sure that it’s safe for you.
Eat a Low-Salt and Low-Potassium Diet
Check with your nutritionist for specific foods that are low in salt and potassium. Our team will tell you when you can increase salt and potassium.
Avoid Sweets and Foods High in Saturated and Trans Fats
Following healthy eating guidelines in the long term will help you maintain good nutritional status.
Maintaining Your Health
For the first three to six months after your dialysis access surgery, you have multiple follow-up visits with the dialysis access team. Gradually, however, you will see our team less often, and instead see your primary care provider and/or your dialysis clinic. You will become even more responsible for maintaining your own health, so it is very important that you:
- Don’t miss any of your scheduled follow-up visits.
- Don’t miss any of your scheduled laboratory tests.
- Eat nutritious foods.
- Exercise regularly.
- Learn to recognize signs of infection at your access site and other complications or problems and report them to your dialysis access coordinator right away.
- Monitor your weight once or twice a week for large gains or losses.
- Take all your medications exactly as they were prescribed.
Your Primary Care Doctor
For regular checkups and common medical problems such as a cold or the flu, you should see your primary care doctor. Let your doctor know that you have had dialysis access surgery. You should also check with your doctor to be sure any medication they prescribe will not interfere with any of the medicines you’re taking following access surgery.
Weight Loss Program
If you have a high body mass index (BMI) and are interested in losing weight, the Dialysis Access Center offers a weight loss program. Weight loss is beneficial to prevent complications before, during and after your surgery. Our nutritionist will provide you with weight-loss tools and resources, such as meal plans, recipes and educational materials. We encourage follow-up appointments every four to six weeks with the nutritionist to check on your progress. You may also benefit from discussions with our Behavioral Health specialists. They can help you address issues linked to overeating, such as depression and stress. They can also help you set strategies and goals.
Beginning Dialysis
When you’re ready to begin dialysis, we are at your side. Our outpatient dialysis services are available at several convenient locations in and around Boston.
Kidney Transplant
While dialysis can improve your health, a kidney transplant may be a more long-term solution to kidney failure. Compared to dialysis, it can help you live longer. Our transplant specialists can provide information if you’re interested in learning more about this surgery.
