Learn why protecting your veins matters when you have chronic kidney disease and how healthy veins may support future care, including hemodialysis access.
This audio summary was created with AI, using the National Kidney Foundation content as the exclusive source. NKF clinical experts have reviewed it for professional accuracy.
About vein preservation
People living with chronic kidney disease may need to protect the veins in their arms for future care. Healthy veins can be used for blood draws, IV medicines (medicines given through a vein), and other treatments. They may also be needed to create an access for hemodialysis.
Hemodialysis moves blood from the body to a dialysis machine and then back into your body. To do this, a surgeon may create an arteriovenous fistula, also called an AV fistula, or an arteriovenous graft, also called an AV graft. Having healthy blood vessels gives your care team more options when planning this access.
Needle sticks, blood draws, IV placements, and other procedures can damage veins. Repeated needle sticks may cause scarring over time. Vein preservation means avoiding damage, so these blood vessels remain available for future care.
Protecting your veins now may help protect your dialysis choices later.
Talk with your care team about vein preservation
As kidney disease progresses, your care team may recommend steps to protect the veins in your arms. This can help keep healthy blood vessels available for future care, including a possible hemodialysis access.
Ask your kidney doctor whether you need a vein preservation plan and what that plan should include. Make sure the plan is added to your medical record and shared with other healthcare professionals, especially before blood draws, IV placement, surgery, or a hospital stay.
You can help protect your veins
Before a blood draw or IV placement
Tell the healthcare professional that you have kidney disease and may need to protect your veins for a future dialysis access. Ask whether the blood draw or IV is needed and which site is safest.
- Ask staff to check your chart for a vein or limb preservation note.
- Ask for an experienced person if the stick may be difficult.
- Ask whether the site can be changed when you need repeated blood draws, so the same vein is not used every time.
- Ask whether the blood test or IV is needed and whether it can be combined with other planned care to avoid unnecessary needle sticks.
Follow the plan your kidney care team gives you about which veins or arms to protect.
During a blood pressure check
If you have an AV fistula or AV graft, do not allow a blood pressure cuff on that access arm. If you are protecting an arm for a future access, follow your kidney care team's instructions about blood pressure checks.
During a hospital or emergency visit
Tell the care team about your kidney disease and your vein preservation plan as soon as you arrive. Hospital and emergency staff may be focused on the problem that brought you in, so you may need to repeat this information.
- Ask for your vein preservation needs to be added to your chart.
- Show staff a medical alert card, bracelet, wristband, or other reminder if you use one.
- Ask the team to explain where they plan to place an IV or draw blood.
- Ask them to contact your kidney care team when there is a question about protecting your veins.
You, your family, or a care partner have the right to ask questions before a needle stick, blood draw, IV, or blood pressure check.
Protect an existing dialysis access
An AV fistula or AV graft is often called a lifeline because it is used for hemodialysis. Tell every healthcare professional which arm has your access.
- Do not allow blood draws or IVs in the access arm.
- Do not allow a blood pressure cuff on the access arm.
- Ask dialysis staff to explain how they are checking and using your access.
- Speak up if something does not feel right or if you are worried about how your access is being handled.
What you can say
It can be hard to speak up, especially when you are sick or in an unfamiliar care setting. These simple statements may help:
- I have kidney disease and need to protect my veins for dialysis access.
- Please check my chart before using this arm.
- Can you explain why this needle stick or IV is needed?
- Is there another safe place you can use?
- Please contact my kidney care team before using this arm.
Plan ahead with your care team
Vein preservation works best when you and your healthcare professionals have the same plan. Ask your kidney care team to document the plan in your medical record and explain how to share it with other care settings.
You may also want to keep the name and phone number of your kidney doctor or dialysis center with you. A care partner can help speak up for you when you are not feeling well.
Questions for your healthcare team
- Do I need to start protecting my veins now?
- Should I protect one arm or both arms?
- Where should blood be drawn or an IV be placed?
- Can you add a vein preservation alert to my medical record?
- What should I tell hospital, laboratory, or emergency staff?
- Should I use a medical alert card, bracelet, or wristband?
- Who should another healthcare professional call if they have questions?
- What should I do if someone uses an arm or vein that was supposed to be protected?
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