Cleaned blood then flows back into your body. This machine is hooked up to a vein in your body. ‚
Over time, piercing the same vein too often may cause scar tissue to form. There may be more chance for blood clots. At some point, the vein may be destroyed. To keep this from happening and to handle more blood flow, an artery and vein are sewn together to make a fistula. This is called an arteriovenous or AV fistula. Since it may take a few months for the fistula to heal and get stronger, surgery will be needed weeks to months before starting dialysis. ‚
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What will the results be?
- Easier to give dialysis
- Less chance for infection
- Less chance of blood clots
- An access site that works longer than other methods
What happens before the procedure?
Your doctor will look at some tests to make sure surgery is safe. Your surgeon will decide which vessels have the best blood supply. It is better to place the graft or fistula in the arm that is not your writing hand/arm. ‚
What happens during the procedure?
You will be given a local pain-killer. A cut is made on the forearm to access the artery and vein to be linked. During the procedure, blood flow is stopped while the artery and vein are cut and joined together. Stitches are used to close the cut. The new vein becomes stronger and larger. Blood flows faster. Access to the vein is easier and can be used over a longer period of time. It may take as long as a few months before the fistula is ready to be used for dialysis. ‚
What happens after the procedure?
If you are not in the hospital at this time, you can expect to go home the same day as your surgery. You can expect very little pain and soreness at the cut site. ‚
You will be closely watched by the staff during your treatments. Your fistula will be checked at each visit before dialysis is started. ‚
A dialysis nurse will check for: ‚
- Signs of infection including warmth or redness of the skin, swelling of the arm with the fistula, drainage or open sores on the fistula arm
- Blood flow in the fistula ¢ ˆ ’ The dialysis nurse will feel your arm for the vibration or "thrill" that can be felt as your blood flows through the fistula. The nurse will also use a stethoscope to listen to the sound of the blood going through the fistula. This is called the bruit.
What follow-up care is needed?
Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits. ‚
What problems could happen?
- Infection
- Blood clot that limits blood flow. If blood clots happen often, you may need a new fistula or the clots may have to be removed.
- Drainage lasts longer than 48 hours
- Coldness and pain in the hand. This needs care right away.
- Numbness in the fingers
- Swelling or bulge at the access site
- Fistula does not happen
- Bleeding
Where can I learn more?
National Kidney and Urologic Diseases Information Clearinghouse ‚
http://kidney.niddk.nih.gov/kudiseases/pubs/vascularaccess/ ‚
National Kidney Foundation ‚
http://www.kidney.org ‚
The Kidney Dialysis Foundation ‚
http://www.kdf.org.sg/ ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚