About Dialysis Fistulas


For anyone who suffers from kidney failure, dialysis is the most common method of treatment. Dialysis fistulas are surgically created access points under the skin that are used to increase the efficiency and safety of dialysis treatments. Through the surgical connection of a vein and an artery, fistulas provide easy access to the bloodstream with a lower rate of complications than grafts or other alternatives. Fistulas must mature before they can be used, which typically requires several months of time following surgery. Although fistulas are generally better tolerated than other forms of dialysis access, complications may develop in some people.


Dialysis fistulas provide easy access to the bloodstream and are typically located in the arms or legs. Dialysis is a procedure that removes blood from the body, circulates it through a machine to remove impurities and restore chemical balance, and then returns the blood back into the body. Fistulas enable dialysis to be performed quickly and safely. Mature fistulas allow for greater blood flow during dialysis treatments, which makes it possible for large amounts of blood to be removed, filtered, and returned in a short period of time.

Time Frame

Once the need for dialysis is determined, fistulas preparation must be begin immediately. Tests are performed to ascertain the proper location of the fistulas, and surgery is scheduled. Once the surgical incision begins to heal, generally three weeks after the surgery, the dialysis fistulas begins to mature. The maturation process generally takes three to six months, but may take as long as 24 months. If the fistulas fail to mature, other access options must be considered. A temporary access point may be used until the dialysis fistulas are mature and able to tolerate the strain of regular dialysis sessions.


Dialysis fistulas are constructed by joining a vein to an artery during a minor surgical procedure. The joint enables greater blood flow, causing the vein to become stronger and larger. As the fistulas mature over time, it eventually becomes strong enough to withstand the insertion of dialysis needles on a regular basis. Fistulas lie beneath the skin and are not normally visible. In some cases, mature fistulas may look like pieces of cord placed beneath the top layer of skin.


Fistulas are generally preferred over other types of dialysis access, such as grafts, because they are less prone to infection and are considerably more durable. Dialysis fistulas maximize the volume of blood filtered during dialysis treatments, resulting in better care and shorter treatment sessions. Moreover, fistulas tend to last significantly longer than any other type of dialysis access.


Not everyone who needs dialysis is a candidate for fistulas. Anyone with a history of artery disease, small veins or reduced circulation will not qualify for dialysis fistulas due to the increased risk of side effects and limited blood flow to the area. Blood flow tests, ultrasounds and a venogram will likely be required to determine if the veins in the arms or legs are large enough and healthy enough to support the placement of the fistulas. Complications may include aneurysm formation, clotting, narrowing of the fistulas, infection and excessive bleeding.

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