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Dialysis AV Fistulas: Helpful Knowledge from Experience

by Derek Benoit, January 28th, 2022

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Fitstula diagram for dialysis access. Image courtesy of Shutterstock.com

Dialysis AV Fistulas: Helpful Knowledge from Experience is my personal introduction for new dialysis patients. Specifically, I tap my own experience with such (this will be my second transplant go-around) to give patients a preview of the new addition to their bodies.

My History with Dialysis AV Fistulas

  • Had my first placed in October of 2011, prior to dialysis followed by
  • Renal transplant in May 2012
  • Fistula placement for current hemodialysis treatment is March of 2022 (at time of writing)
  • Renal/ pancreas and renal transplant date TBD

What is a Dialysis AV Fistula and What does it Do?

A dialysis fistula is a surgically created joint between a vein and artery. The surgery is typically done in day surgery at BIDMC, where I’m a patient. A dialysis fistula is needed to allow for a permanent access through which cleaning of the blood and removal of fluid can be performed via hemodialysis. Should dialysis be required immediately, a central venous catheter will likely be placed to allow for immediate use. Important to note is that it is NOT a permanent dialysis access. Specifically, the CVC and and does eventually require replacement in most instances. I had major clotting issues that required several replacements of my CVC since original placement in October 2021.

Most critical for patients needing a dialysis access is that time is your friend. The earlier you can have the AV fistula surgically placed, the better. Moreover, the longer you allow the AV fistula to mature, the fewer issue you will have when first using it. Under no circumstances should you delay having the access placed. Please talk with your transplant or general nephrologist about getting an evaluation and scheduling the procedure as early as possible!

When Should I Get a Dialysis AV Fistula Placed?

Ideally, a dialysis fistula will be placed with time to spare before dialysis is required. Moreover, it takes a solid 3 months or so for a fistula to “mature.” Specifically, the fistula must develop and strengthen after it’s placement to handle the high pressures associated with hemodialysis.

What Else Should I know about Dialysis AV Fistulas?

  • Fewer clotting issues than central venous catheter access
  • Lower risk of infection than central venous catheter access
  • Must be reasonably protected, just like a central venous catheter access
  • May become unusable and require replacement (for future transplants)
  • Requires monitoring during dialysis period
  • Surgeon will choose most ideal placement

For More Information on Renal Disease and Treatments, Please Visit: The National Kidney Foundation at: https://www.kidney.org/

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