The Bleeding Access

Dialysis vascular access bleeding is a common complication that may range from prolonged bleeding after dialysis to fatal exsanguination. It can be caused by both local and systemic factors. Proper emergent management is required to minimize significant blood loss and even the risk of death. Almost all dialysis access bleeding can be managed without sacrificing the access. A bleeding access associated with significant tissue defect, infection, or aneurysm formation usually requires definitive surgical intervention to prevent fatal exsanguination. Recognizing and managing the predisposing factors can reduce the occurrence of significant bleeding and associated morbidities.