- By Dr Vikas Singh,
M.B.B.S., M.S., M.Ch.
Urologist, Genito Uro Oncologist and Kidney Transplant Surgeon,
Kokilaben Dhirubhai Ambani Hospital, Indore.
What is an AV fistula?
An AV fistula is a surgical connection made between an artery and a vein in the arm to create a site for dialysis. Dialysis is a medical treatment used for patients with kidney failure to remove excess fluids and waste products from their blood.
Why do I need an AV fistula?
If you have chronic kidney disease and require dialysis, you will need an AV fistula to access your bloodstream during treatment. An AV fistula is the best method to access the bloodstream as it provides a better flow rate and is less likely to cause infection or blood clots.
What happens during the AV fistula surgery?
During the surgery, a surgeon will create a small incision in the arm to expose an artery and a vein. The surgeon will then connect the two vessels using a small piece of tubing, called a graft. This connection allows blood to flow from the artery into the vein, creating a larger and stronger vein that can be used for dialysis.
How long does the surgery take?
The surgery usually takes around two to three hours.
Will I be put to sleep during the surgery?
Yes, you will be given general anesthesia during the surgery, so you will be asleep throughout the procedure.
What are the risks of AV fistula surgery?
Like all surgeries, there are risks associated with AV fistula surgery. These risks include:
Problems with the graft
Your surgeon will discuss these risks with you before the surgery and explain how they will minimize the risks during the procedure.
What happens after the surgery?
After the surgery, you will be taken to a recovery area where your vital signs will be monitored. You may experience some discomfort and swelling around the incision site, but this should subside within a few days. You may be given pain medication to help manage the pain.
You will need to keep the incision site clean and dry to prevent infection. Your surgeon will give you specific instructions on how to care for your incision site.
When will I be able to start dialysis?
It usually takes around four to six weeks for an AV fistula to mature enough to be used for dialysis. Your doctor will monitor the progress of your fistula during this time and let you know when it is ready to be used.
Will I need to make any lifestyle changes after the surgery?
You will need to avoid heavy lifting or strenuous activity for the first few weeks after the surgery to allow the incision site to heal. Once your fistula has matured, you will be able to resume your normal activities.
You may need to make some changes to your diet to help manage your kidney disease. Your doctor or dietitian will give you specific instructions on what foods to eat and what foods to avoid.
What are the benefits of an AV fistula?
AV fistula surgery is the preferred method of access for dialysis because it has several benefits over other methods:
It provides a higher flow rate, which means the dialysis treatment is more efficient and takes less time.
It is less likely to cause infection or blood clots.
It is more durable and less likely to need repair or replacement.
Can I choose not to have an AV fistula?
If you have kidney disease and require dialysis, an AV fistula is the best method of access. Without an AV fistula, other methods of access, such as a catheter or graft, are more likely to cause infection or blood clots.
How long will my AV fistula last?
An AV fistula can last for many years with proper care. However, over time, it may become less effective, and you may need to have it repaired or replaced.