AV Fistulae

What is a Fistula for Dialysis?

An arteriovenous (AV) fistula is the most optimum access to the blood stream needed before the treatment of hemodialysis. Such an access facilitates the speedy and high volume traversing of the blood to and fro the dialysis machine so as to remove the waste/ toxins/ extra unnecessary fluids from the patient’s body.
The normal blood flow is through the arteries to capillaries, finally to the veins. In case of AV fistula, the capillaries, are skipped and blood flows from arteries to the veins. In an AV fistula, which is located just under the skin, a connection is made between a vein and the artery to create a rapid blood flow.

Safety:

  • As safe as traditional open surgeries.
  • The patient’s own vessels are used, so secure.
  • No permanent placement of external materials.
  • Lower infection risk.
  • Speedy recovery.
  • Minimal treatment time.
  • Greater blood flow.
  • Lower clotting tendency.
  • Less expensive care.
  • Longer durability.

Causes Of Kidney Failure:

  • Diabetes.
  • Hypertension.
  • Ignoring the early stage symptoms.
  • Hereditary.
  • Polycystic kidney disease.
  • Kidney inflammation.
  • Congenital abnormalities.
  • Auto- immune diseases.

When Does The Need For A Dialysis Arise:

  • Kidney functioning abnormalities.
  • Advanced stage kidney malfunctioning.
  • Fatigue.
  • Cramps in muscles.
  • Shortness of breath.
  • Nausea
  • Vomiting.

Diagnosis:

In case, the kidney function reduces to lower than 10 to 15 % of the normal dialysis, then a transplant is necessary. Hemodialysis can take over the kidney’s functions like detoxicating the blood, removal of extra fluids, waste, etc.

The arteriovenous fistula is used for an effective Hemodialysis.

  • MRA- Magnetic resonance angiography.
  • Duplex ultrasound.
  • Blood flow analysis.
  • CT- Computerized tomography angigram.

Preparation:

  • Blood pressure tests.
  • Avoid heavy weight lifting.
  • Avoid tight jewelry/ tight clothing near the access area.
  • Avoid putting pressure on the access arm. Eg: sleeping on access side, working the access arm too much, etc.
  • Daily checkup of the access pulse.
  • Maintain the access arm and area clean pre treatment.

Risks:

  • Bleeding.
  • Access site bulge.
  • Prolonged maturity.
  • No maturity in rare cases.
  • Blood clots.
  • Stroke.
  • Weakness.
  • Leg pain.
  • Pressure on the heart.

Follow- up:

  • Maintain the access arm and area clean pre treatment.
  • Overnight hospital stay for observation.

When to see the doctor:

  • Fever.
  • Swelling/ redness around the fistula area.
  • Pain/ tenderness around the fistula area.

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient. Only a well experienced urologist should perform the above treatment.

Dr Prabhudev M Salanki provides best treatment for kidney failure in India,Bangalore at affordable price.