Your doctor will refer you to a surgeon who will discuss what type of blood access is most suitable for you.
A surgeon will create an access to your blood stream (“fistula” or “graft”), usually in the arm, sometimes in the leg.
Before treatment starts, two fistula needles are inserted into the blood access to allow blood to flow, to and from the HD machine, via a special tubing set, during the treatment. The fistula needles are removed when the treatment is completed.
Note – Per ERBP Guidelines 2015 Recommendations:
"Patients with D.M. and starting on H.D., tunneled catheters should be avoided. Native vascular access shown to have better results."