Kidney failure necessitates life-sustaining treatments like dialysis. Hemodialysis involves filtering a person’s blood outside the body using a machine. A consistent and reliable method of accessing the bloodstream is required to connect to the dialysis machine.
Understanding Dialysis Access
Dialysis access refers to the site on the body where blood is removed, circulated through the dialysis machine, and then returned. Hemodialysis requires a significant volume of blood flow, typically hundreds of milliliters per minute, to efficiently remove waste products. Repeatedly inserting needles into regular veins for each treatment would quickly damage them. Therefore, a specialized, durable access point is created to facilitate high blood flow and withstand frequent needle insertions, ensuring consistent and effective blood filtration.
The AV Fistula: How It Works
An arteriovenous (AV) fistula is a surgical connection created between an artery and a vein, most commonly in the arm. This procedure directly joins a high-pressure artery to a lower-pressure vein. Over several weeks to months, increased blood flow and pressure cause the vein to enlarge and thicken. This maturation transforms the vein into a robust vessel capable of supporting repeated needle insertions for hemodialysis, providing a durable and accessible site for efficient blood removal and return.
Why AV Fistulas Are Preferred
AV fistulas are the preferred method for long-term hemodialysis access due to several advantages. They have a lower infection risk because they use the individual’s own blood vessels, not artificial materials or external lines. Fistulas also exhibit superior durability and longevity, often lasting for many years, reducing the need for frequent access revisions. Natural blood flow through a fistula leads to a lower incidence of complications like clotting and narrowing, which are more common in synthetic grafts or catheters.
The high blood flow rate with a well-developed fistula allows for more efficient dialysis, ensuring optimal waste removal. This improved efficiency contributes to better health outcomes for individuals undergoing dialysis. Reduced access-related issues, like infections or blockages, also mean fewer hospitalizations and interruptions to daily life. This enhanced reliability and fewer complications contribute to an improved quality of life for individuals receiving long-term dialysis.
Living With an AV Fistula
Creating an AV fistula typically involves an outpatient surgical procedure, allowing individuals to return home the same day. Following surgery, there is a crucial maturation period, ranging from several weeks to a few months, during which the fistula develops and strengthens. During this time, the fistula is not yet ready for dialysis, and alternative access methods may be used. Protecting the fistula arm is paramount; avoid blood pressure cuffs, blood draws, or tight clothing on that arm to prevent damage or compression. Regular monitoring for complications like swelling, redness, or pain, is also important. Some individuals may be advised to perform exercises, like squeezing a rubber ball, to promote maturation and enlargement of the vein.