Kidney dialysis is a medical process in which toxins are removed from the blood when the kidneys are not working well enough to do this naturally. A dialysis fistula is a method of securing a common access point for this procedure. Through this method, an artery and a vein are connected to each other in order to make needle insertion easier during dialysis. The forearm is usually used to create the dialysis fistula.
The dialysis fistula is often referred to as an AV fistula. This stands for arteriovenous fistula, as it requires joining an artery to a vein. This is the preferred type of access for dialysis because this method has a low risk for blood clots or infection. The dialysis fistula is also known to last several years, another advantage over other types of vascular access. The down side of this procedure is that the completed fistula often needs several months to heal and mature before being used as an access point for dialysis.
The surgical procedure used to create the dialysis fistula is often done on an outpatient basis. Frequently, the patient is only given a local anesthetic. This means that the patient remains awake during the surgery, preventing possible negative side effects of general anesthesia.
By joining the artery to the vein, blood flow to the vein is significantly increased. This makes the vein grow larger and become stronger. Since dialysis treatments are often needed several times per week and needle sticks are a requirement for this type of treatment, a strong vein becomes very important to the patient. Without this procedure, a normal vein could easily collapse or become otherwise damaged by repeated needle sticks, especially considering the relatively large size of dialysis needles.
Although the dialysis fistula is the preferred method used, it is not always a possibility. There are occasions when the surgery is performed, but for one reason or another the fistula never matures enough to be a viable access option. There are other times when the kidneys fail suddenly and there is not enough time to wait for a dialysis fistula to mature, making other options more practical. Some patients choose not to have the fistula created at all due to the large bulge caused by the procedure, as they feel it is unattractive or may draw unwanted attention.
It is important that blood flow to the dialysis fistula is not restricted. For this reason, the patient will need to avoid wearing tight clothing over this area. Medical procedures such as having blood pressure monitored or blood drawn should be done from the non-access arm. Daily monitoring of the pulse in the access arm will also detect any potential blood flow problems.
