The importance of opening a fistula for dialysis:

Chronic renal failure is a disease caused by the inability of the kidneys to function and to excrete harmful substances from the body through urine. Chronic kidney failure can be caused by many conditions such as diabetes and high blood pressure. When the kidneys cannot function as before, dialysis becomes inevitable. The main purpose is to withdraw dirty blood from the body and return it to circulation after being cleaned by the dialysis device.

There are two methods used for chronic kidney failure patients to undergo dialysis. One of these two basic methods is required to start dialysis.

1- Arterivenous Fistula (AVF)

Arteriovenous fistula; It is performed in a short operation and is basically performed by connecting the artery and vein in the arm of appropriate diameter.

2- Dialysis catheter (Permanent or Temporary)

In the catheter method, a plastic cannula is placed into the neck or groin veins.

The first choice for dialysis is arteriovenous fistula due to its low risk of infection and longer duration of use. Since the dialysis catheter is a foreign object and a part of it remains outside the body, the risk of infection is high and treatment is difficult and tiring for the patient. Catheter insertion for dialysis should be the last choice, except in very urgent cases and when the veins are not of suitable diameter. Therefore, it is recommended to open an arteriovenous fistula (AVF) for patients who are planned for dialysis due to renal failure and are currently on dialysis.

Arteriovenous fistula operation is performed with small incisions of 1.5-2 cm and takes approximately 60-90 minutes. The procedure is performed under operating room conditions and patients are usually discharged on the same day. After the successful procedure, patients can undergo dialysis through the fistula opened within an average of 2 months.

Although the fistula procedure is the healthiest method for patients, fistula obstruction caused by blood clots due to kidney failure may occur. In such a case, it is recommended to open a fistula to the appropriate arm veins before inserting the catheter.

Dr. Hasan Ceyda
Cardiovascular Surgeon

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