Dialysis Access Institute

The Dialysis Access Institute (DAI) was established at Regional Medical Center (RMC) in March 2011 to serve patients with end-stage renal disease whose access to the bloodstream needs to be established or has been compromised. Featuring some of the leading dialysis access surgeons in the world, DAI specializes in obtaining, maintaining and salvaging access to the bloodstream using the latest techniques and technology.

Led by renowned surgeon and DAI Medical Director John Ross, MD, DAI performs more than 3,700 procedures/operations each year, and physicians from throughout the world visit RMC to be trained in these procedures.

Interior view of operating room.DAI is a unique, one-of-a-kind facility that has been designed to promote excellent patient care in a very timely fashion. The majority of procedures are performed on an outpatient basis, and patients have designated parking with covered entrances for both patient and drop-off ambulance entrances.

DAI is accredited by the American Society of Diagnostic & Interventional Nephrology as a hemodialysis vascular access training center. Accordingly, DAI provides educational programs for physicians, nurses and technologists regarding dialysis access, both on site and through live video streaming, so that best practices can continue to be developed and reviewed for the patients.

What is Dialysis Access?

Dialysis access allows patients with end-stage renal disease to be connected to a dialysis machine so their blood can be withdrawn, purified and returned to the bloodstream. Due to the large caliber needles used in dialysis and the frequency of dialysis treatments (about 3 times per week), the blood vessels through which access takes place must be prepared to withstand the rigors of frequent dialysis treatments. DAI offers the very latest dialysis access procedures, most common of which are the arteriovenous fistula, arteriovenous graft, catheter, peritoneal dialysis and the recently FDA-approved percutaneous arteriovenous fistula.

Arteriovenous Fistula

An arteriovenous (AV) fistula is created when an artery is connected directly to a vein, usually in the forearm. This allows blood to flow into the vein, causing it to grow larger and stronger so it can withstand repeated needle insertions for dialysis possible. Fistulas have proven to be beneficial for long-term dialysis because they can last longer and are less likely to become infected or clotted.

Percutaneous Fistula

DAI was the first hospital in South Carolina and one of just a handful in the country to offer this new, minimally invasive procedure. The percutaneous AV fistula uses an implantable device to create an AV fistula, eliminating the need for surgery and drastically reducing recovery time and the time it takes for vein to become ready for dialysis. The ease and convenience of this groundbreaking new option for dialysis access should improve the patient experience and enhance the quality of care for patients with end-stage renal disease. Percutaneous creation of arteriovenous AV fistulas can also be completed by endovascular surgeons, which will greatly increase the number of patients who receive the procedure.


If kidney disease has progressed quickly, you may need to have a venous catheter, which provides temporary access to the bloodstream for dialysis treatments. A catheter is a tube that is inserted into a vein in your neck, chest or leg. A catheter has two chambers that allow a two-way flow of blood so needle insertion is not needed. Catheters are not ideal for long-term access due to an increased risk of infection, but they can be used temporarily while a permanent access is being established. DAI uses the most advanced laparoscopic techniques to minimize catheter dysfunction.

Peritoneal Dialysis

Peritoneal dialysis (PD) is a treatment that uses the lining of your abdomen (belly area) called the peritoneum and a cleaning solution called dialysate to clean your blood. Dialysate absorbs waist and fluid from your blood using your peritoneum as a filter.


  • 16,000-square-foot facility
  • 6 Pre-op stations.
  • 6 Post-op stations.
  • 6 Operating/procedure suites (2 of which have live video streaming capabilities).
  • Digital radiology equipment.
  • Hemodynamic monitors in each room.
  • Spacious, comfortable waiting room.
  • Covered canopies at both patient drop-off and ambulance entrances.
  • Total emergency back-up power throughout the facility.

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