Arterio-Venous Fistula (AVF) are created for patients with end-stage (stage 5) renal failure so their veins can be used for haemodialysis. Kidneys clean and filter your blood from waste and toxins but if you have lost more than 85% of your kidney function, you will need kidney dialysis to the work. The most common causes for kidney failure are diabetes, hypertension and auto-immune disease such as lupus (SLE).

Image Source: Diabetes Daily

In haemodialysis, the artificial kidney (haemodialyser) takes blood from your body, cleans the blood before returning the blood into your body. It also helps to maintain your blood pressure and balance important minerals such as sodium, potassium and calcium in your blood. The process usually takes around 4 hours and has to be repeated 3 times a week.  It may take longer depending on how heavy you are, how much kidney function and how much waste you have in your body.

AVF allows the haemodialyser to get access to your blood. The surgeon will perform a minor surgery under local anaesthesia using your own vein (native AVF) or a prosthetic graft (synthetic AVF).

A successful native AVF can be used within 6-8 weeks when it is called a mature fistula. If the fistula does not mature after 2 months (called poor fistula maturation) and it can be matured via Balloon Assisted Maturation or open AVF repair procedure. Prosthetic graft fistulas take 2-3 weeks to mature.

Signs of AVF not working well

• Infection (watch out for redness, warm feeling over the fistula area or pus)
• Blockage (watch out for swelling of your arm and hand)
• ‘Steal syndrome’ whereby blood is directed away from your hand (watch out for numbness or pain in the hand)

Photo of Graft Infection

Take good care of your AVF

Your AVF vein access is your lifeline and you must do your part to look after it. Wash the area around the AVF with soap and warm water every day. When blood is flowing through your AVF, you can feel a vibration over the area which means it is working well. Inform your dialysis nurse or doctor if you notice any changes so that action can be taken to save the AVF.

Download TELEME app and connect with your Vascular Surgeon or your nephrologist if you experience signs of arterio-venous fistula problem