If you are on hemodialysis, your fistula or graft is how the machine reaches your blood. When it narrows or clots, dialysis can be delayed. FCCI has a 10-year tradition of caring for people with chronic kidney disease and has performed thousands of access procedures in its outpatient cath labs in Duval and Putnam counties.
Signs your access needs attention
Tell your dialysis team right away if you notice changes.
- The thrill (buzz) you usually feel is weaker or gone
- The arm is swollen, cold or painful
- Dialysis is taking longer or alarms more often
- Bleeding lasts longer after needles come out
- Redness, warmth or drainage at the site
What FCCI does for fistulas and grafts
FCCI's access maintenance includes angiograms, declots (thrombectomy), angioplasty and stent placement, pseudoaneurysm repair with endograft placement, embolization management and access steal syndrome care including the miller banding procedure.
Ultrasound and catheter care
FCCI offers artery and venous ultrasound, DVT studies, AVF mapping and central venous studies. A hemodialysis fistula or graft duplex takes 20 to 30 minutes. FCCI removes tunnel catheters and places temporary catheters for emergent dialysis; it does not place tunneled catheters.
Working with your kidney team
FCCI's cardiologists work closely with your nephrologist and dialysis center, giving immediate feedback. Point-of-care stat labs check potassium and hemoglobin, and the team can advise whether dialysis is urgent or can safely wait until the next day. FCCI says this approach has reduced infection rates, hospital trips and catheters for its patients.
Protect your access every day
Do not let anyone take blood pressure or draw blood from your access arm. Avoid tight sleeves, watches or sleeping on that arm. Check for the thrill daily. Keep the site clean.
Why patients choose FCCI
FCCI has served the region since 2002 with board-certified physicians in Duval, Clay, St. Johns, Putnam and Ware counties. Much of its care happens outside a hospital: it was first in the region to offer outpatient catheterization, in labs accredited by the Accreditation Association for Ambulatory Health Care. It takes Medicare, Tricare, Blue Cross Blue Shield, Aetna, Cigna, United Healthcare, Humana (with some exceptions) and many other plans.
Ultrasound for dialysis patients
A hemodialysis fistula or graft duplex uses ultrasound to see blood flow through your access directly. FCCI's lab notes it can detect a fistula or graft that is starting to fail, which can keep you from missing treatment.
Your doctor may order it if you have nausea, loss of appetite, fatigue, weakness, changes in urination, muscle cramps or foot swelling. It takes 20 to 30 minutes, and the lab is set up for the long-term follow-up people with dialysis access often need.
Planning around your dialysis days
Mention your dialysis schedule when you call so the visit does not collide with a treatment. Bring notes from your dialysis unit about any trouble with pressures, bleeding or cannulation, plus your medicine list.
Reach FCCI at 904.493.3333, or 904.644.0092 in Orange Park and 386.325.2836 in Palatka, or go through the booking page. Your kidney team and FCCI can give you advice for your own access; this post cannot. If the thrill is gone or the arm turns cold, call your team right away, and call 911 for heavy bleeding.
