Dr. Spinowitz explains what Dialysis Access Management is.

The dialysis access, as we explained before, could be either fistula, graft, or catheter, whether it's hemodialysis catheter or peritoneal dialysis catheter. All of these accesses are unnatural.

The body does not want to have an artery attached to a vein, it does not want to have an external foreign body introduced into the vein or into the peritoneal cavity. Because everything is unnatural, the body in a way, tries to fight what's going on. The body will react with either scar tissue or narrowing, if it gets irritated, or inflamed, this will all cause dysfunction for the access.

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