When a person’s kidneys fail, dialysis is often required if transplantation cannot be performed. Dialysis can be performed by filtering the blood. In turn, blood for filtration can be obtained via a catheter or arteriovenous fistula (AV fistula). Catheters can be placed on short notice but have a short usable life-span and are difficult to care for. By contrast, a fistula requires surgery and cannot be used until they heal, but can last for years. Your nephrologist has recommended hemodialysis via a surgically constructed AV fistula
.Fistula, which your vascular surgeon constructs by joining an artery to a vein.
If all goes well, you will go home several hours after surgery. At home, you can gradually resume normal activities as tolerated, but should work up to things slowly. You will be sore and should plan to have someone at home with you to help with meals, house keeping, grocery shopping, and so on, for the first few days or so. You may have a drain; we will give you appropriate instructions and make arrangements for removal. You may remove your dressings and shower/wash the second day after surgery unless other instructions have been given or you still have a drain. You will see your surgeon 2 weeks after discharge for routine follow-up, and 6 weeks after surgery to check the fistula with ultrasound. Once the fistula is functional, we will remove your catheter, if present. We will usually recommend lifelong visits to check the fistula at 6-month intervals.
In the context of this article, dialysis access is an entranceway into your bloodstream that lies completely beneath your skin and is easy to use. The access is usually in your arm, but sometimes in the leg, and allows blood to be removed and returned quickly, efficiently, and safely during dialysis or, less commonly, for other procedures requiring frequent access to your circulation.