Hemodialysis is the cleaning of blood through an artificial kidney. In order to clean the blood, patients need to be able to access their body’s blood supply. Cannulation or “sticking” is the insertion of a needle into a blood vessel. This appears to be the biggest concerns patients have when considering DHHD as they or their partner will have to learn the cannulation process in order to perform their dialysis safely at home.
Our nursing educators with several years experience in DHHD have trained dozens of patients in the cannulation process and have helped the most difficult to train patients to overcome the “sticking” fears in matter of days. The key to successful self cannulation although to some degree depends on the patients, comes from an experienced nurse who can make this part of the training process as smooth as possible.
There are two different cannulation techniques. The traditional needle insertion uses different needle insertion sites for each dialysis.
The buttonhole, however, uses the same exact site spot for consecutive dialysis and is associated with fewer complications as compared with the conventional method. The Buttonhole technique can ONLY be used on patients with a fistula. Home Dialysis Centers does practice the buttonhole technique on all fistula patients giving them a better cannulation protocol.
The majority of our patients have fistula and those starting from pre-ESRD are encouraged to have a fistulas put in but other accesses such a graft or a venous central catheter can also be used.
