AV Fistula


Fistula should be done before the time of dialysis, so that it matures and gives good blood flow. AVF can be made when Cr. is 3 – 4 mgs%. This is done by an operation under local anesthesia.


An AV Fistula is made to felicitate taking out blood for dialysis and for returning. During the operation, the fistula will be made by joining an adjacent vein and artery at the wrist, this will cause the veins to enlarge and develop thick walls needed for dialysis.

After the operation, your fistula will take approximately 6-8 weeks to develop however, sometimes it may take longer. Before you leave hospital you will be shown how to check if your fistula is working.

Before you can have the operation you will need to make an appointment to see a vascular surgeon.
At this appointment the surgeon will decide where your fistula will be placed and will explain any possible complications. Arrangements for surgery will be made and you will be asked to sign a consent form.

If the decision is made to place the fistula in your arm, do not have your blood pressure taken or have needles placed in that arm before or after your operation.

What will happen during your stay in hospital?

  1. The operation may be performed under local anaesthetic. You will return from the operating theatre with a dressing on your wrist or hand depending on where you where operated on. Usually the dressing can be removed the day after the operation.
  2. You will have stitches in the area of the fistula. These stitches will be removed approximately 10 – 14 days after you leave hospital. Usually this will happen during your follow-up appointment with your surgeon.
  3. You will probably be discharged home the day of the operation. Until you are discharged, a nurse will visit you to listen to your fistula and make sure that it is working.
  4. If the fistula is in your arm, try to keep your arm elevated by resting it on a pillow.
  5. You may experience some pain. After the operation if you feel some pain please tell the nurse. Pain relief will be organized for you so that your stay in hospital is as comfortable as possible.

When you go home, how will you care for your fistula?

It is very important that you check your fistula 3 times a day: when you wake up, at lunch time and just before you go to bed by feeling or listening to make sure that it is working properly.
Do not wear anything tight around the area of the fistula such as tight clothing, jewelers or watches.

If the fistula feels weak or not working as normal, contact the hospital immediately. A few hours might make all the difference between saving the fistula or having it close over. Also if you have any redness, swelling or pain in the area of the fistula, contact your Nephrologist / Urologist.