• AV fistula. A minor surgical procedure may be done to connect an artery and vein, creating a fistula. This causes arterial blood to flow directly into a vein. The vein gets larger, allowing easier access for dialysis. The fistula takes around 12 weeks to mature and must be placed several months before dialysis is anticipated. A fistula provides the best access for hemodialysis and can last for several years.
It is critical that veins in patients at high risk to develop kidney failure are preserved. This may include avoiding blood pressure checks and intravenous (IV) or lab draws from the arm. This maximizes the chance for creating a functioning AV access when needed.
Although a fistula is the most desirable access to use for hemodialysis, it may not be possible. If the veins are not large enough or there is no time to wait for a fistula to mature, a graft or catheter may be used.