Creation and Maintenance of Dialysis Access
Before beginning dialysis, your kidney specialist may recommend you have a procedure to create a “Fistula”. This is a surgically created vein to allow waste products to be removed from the bloodstream when the kidneys are failing. This dialysis machine acts like an artificial kidney and returns the clean blood through the same vein.
There are several benefits of a fistula:
- The high rate of blood flow through the surgical vein allows the blood to be exchanged quickly
- The fistula can be accessed as many times as needed
- There is a lower chance of infection, particularly when using your own vein
- Lasts longer then many other forms of dialysis
How is the fistula created?
The vessels on your arms and sometimes legs will be assessed by ultrasound so your surgeon can find the best location for your fistula.
The procedure can often be performed under local anaesthetic or by numbing the nerves to the area. The artery (takes blood from the heart) and vein (takes blood back to the heart) will be joined at the site chosen. This allows the high blood flow to be redirected to the fistula vein to be dialysed. The procedure is often performed as a day surgery.
What are the risks?
There are some risks associated with the procedure including the fistula not growing strong enough for dialysis, this may require stretching with a balloon to help. Bleeding, infection, damage to the nearby vessels or numbness in the area. The chance of having a problem is small and some medications will be given during the procedure to reduce these risks.
- Antibiotics are given before the procedure
- Blood thinning medication is given during the procedure
Your doctor will discuss all this with you before proceeding with the operation.