Dialysis Access Management Specialist

Kenneth Spearman, MD -  - Vascular & Vein Center

Central Coast Vein & Vascular

Kenneth Spearman, MD

Vascular & Vein Center located in Arroyo Grande, CA

In the late stage of chronic kidney disease, dialysis is required to filter your blood. Once you start dialysis, you need ongoing dialysis access management. Kenneth Spearman, MD, at Central Coast Vein & Vascular, provides access point procedures and ongoing maintenance to ensure your dialysis treatment is seamless. If you have questions about dialysis access management, call the office in Arroyo Grande, California, or schedule an appointment online.

Dialysis Access Management Q&A

When do I need dialysis access management?

Chronic kidney disease progresses to cause end-stage kidney disease or kidney failure. At this stage, your kidneys stop filtering wastes out of your blood, and you need dialysis to take over for your kidneys.

Before you can receive dialysis, you need a minor procedure to create an access point. And after access is created, you need ongoing management to ensure the dialysis access point stays healthy and viable.

What are the different types of dialysis and dialysis access?

You can receive one of two types of dialysis, hemodialysis or peritoneal dialysis.


Access for hemodialysis is typically created in one of your arms by connecting an artery to a vein. Following this procedure, the vein gets larger and thickens. This allows your blood to flow more quickly during hemodialysis.

To start hemodialysis, your provider inserts two needles into the access point, connects each needle to a tube, and attaches the tubes to the dialyzer, which is the machine that filters your blood.

Blood travels through one tube into the dialyzer, flows through filters, and then out of the machine and back to your body through the second tube.

Peritoneal dialysis

If you choose peritoneal dialysis, your access is created by inserting a flexible catheter into your abdomen. When it’s time to perform your dialysis, you connect the catheter to a bag that contains dialysate fluid.

Fluid flows from the bag into your abdomen and then stays in your abdomen for a prescribed length of time, pulling wastes out of the blood vessels lining your abdomen. When you drain the dialysate, it carries away the wastes.

What services should I expect with dialysis access management?

Dr. Spearman provides access point procedures and on-going management needed to ensure your dialysis access remains clear and healthy.

Hemodialysis management

Your hemodialysis access can become blocked due to blood clots. To diagnose the problem, Dr. Spearman performs a fistulogram or a venogram. Both procedures use X-ray imaging and a dye that’s injected into your blood vessels and shows up on the X-ray. 

During a fistulogram, the dye shows blockages or narrowed vessels affecting the fistula or graft. A venogram reveals blood clots in your veins.

Depending on the results of your diagnostic imaging, Dr. Spearman performs a thrombectomy or thrombolysis to remove a clot. If the vessel has narrowed, he performs a balloon angioplasty to widen the blocked area. 

Peritoneal dialysis management

Peritoneal dialysis access may develop problems such as dialysate leakage, infections, or catheter dysfunction. Dr. Spearman typically performs ultrasound imaging or a CT scan to diagnose the problem and determine the appropriate repair or treatment.

If you need dialysis access management, call Central Coast Vein & Vascular or book an appointment online.