Arteriovenous fistula care in haemodialysis patients

In the information is the power. That's why we want to give you a simple and easy to consult guide to arteriovenous fistula. We consulted Dr. Patricia Rodriguez, a nephrologist since 22 years ago for Baxter Renal Care Services.

Let's start with the fundamentals, what is an arteriovenous fistula?


In the case of haemodialysis patients, it is a very practical option that optimizes the whole process and makes things easier for both the patient and the attending physicians.

As Rodriguez explains, arteriovenous fistula (or AV fistula) “is the union of an artery with a vein in one of the arms at wrist level below the skin. The artery forces blood out of the bloodstream, and the vein offers its thick gauge to bring blood back into the bloodstream.” This binding allows a channel to be created that can be easily punctured by the needles used in haemodialysis

How does it work?

Fistula is created in the patient's arm through a simple surgical procedure. After that, wait four weeks for it to heal and thicken naturally with the patient's blood flow. After four weeks, and with the help of a series of exercises the doctor will instruct, the
fistula will be ready for punctures.


What are the advantages of arteriovenous fistula?

As Rodriguez points out, “the risk of infection is much lower” compared to
catheters, because fistula is “not a foreign body.”


What care should I take?

Once a fistula is created, the patient should care for the wound to ensure that it is bleeding and should check that it is always clean and dry. The arm with the fistula should be kept at rest and elevated for the first few days; not use it to lift heavy things or allow it to be used to take pressure or be punctured for laboratory samples.

In the long term, it is not recommended to sleep on that arm or wear clothes that are too tight. Of course, the fistula area should always be kept clean, the patient should clean it with soap and water.


What warning signs should I consider when seeking medical assistance?

To know that the fistula is healthy, the doctor will teach the patient how to feel it to feel a kind of vibration known as “thrill.” This indicates that the fistula is still alive. If you do not feel the palpable vibration or notice something unusual in the fistula, you should seek medical advice as soon as possible. Finally, Rodriguez recalls that “signs of
infection, such as redness, warmth, pain, or visibly discharge or
discharge, should be considered as signs of infection.”