Abstract: A dialysis access is disclosed. The dialysis access includes a tubular base, an initial access structure, a persistent access structure, and a seal. The initial access structure is retractably disposed within an interior of the tubular base and includes a piercing tip. The initial access structure is retractable from an extended position to a withdrawn position. The persistent access structure is coupled to the tubular base and surrounds and extends along a length of the initial access structure with the piercing tip exposed while in the extended position. The persistent access structure remains stationary relative to the base with the initial access structure in the withdrawn position. The seal is disposed within the tubular base to surround the initial access structure while in the extended position and to isolate the initial access structure from a fluid flow path within the tubular base while in the withdrawn position.