Complications of arteriovenous fistula in dialysis patients: Incidence and risk factors in Taif city, KSA (2024)

  • Journal List
  • J Family Med Prim Care
  • v.9(1); 2020 Jan
  • PMC7014907

As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsem*nt of, or agreement with, the contents by NLM or the National Institutes of Health.
Learn more: PMC Disclaimer | PMC Copyright Notice

Complications of arteriovenous fistula in dialysis patients: Incidence and risk factors in Taif city, KSA (1)

HomeCurrent issueInstructionsSubmit article

J Family Med Prim Care. 2020 Jan; 9(1): 407–411.

Published online 2020 Jan 28. doi:10.4103/jfmpc.jfmpc_848_19

PMCID: PMC7014907

PMID: 32110627

Majed Mansour Aljuaid,1 Nawaf Najim Alzahrani,1 Abdulrahman Abdulaziz Alshehri,1 Lama Humaied Alkhaldi,1 Faisal Sultan Alosaimi,1 Nawwaf Waiel Aljuaid,1 Omar Ahmed Asiri,1 and Ayman Ahmad Atalla2

Author information Article notes Copyright and License information PMC Disclaimer



The aim of this study was to measure the prevalence of arteriovenous fistula (AVF) and its complications in patients undergoing hemodialysis (HD) in Taif Region, Saudi Arabia.


This was a prospective hospital-based study conducted on 196 patients aged above 18 years who were undergoing dialysis in two hospital Taif City. Data collected and documented using a pretested questionnaire, which included sociodemographic details and also information about fistula-related complications. Hospital records were also reviewed to match the complication and related risk factors. Appropriate statistical tests were used and analyzed with SPSS software ver. 23.


Majority of the study patients were in the age group of 41–60 years and the prevalence in male and female were 49.5% and 50.5%, respectively. The most prevalent chronic illness in the patients was hypertension (41.7%) and more than 30.6% had multiple chronic illness. The most common type of AVF was radiocephalic fistula (RCF). The most common complication associated with the patients with AVF was ischemic neuropathy (29.6%). Smokers had significant history of myocardial infarction than non smokers.


Early and timely detection of complications in AVF is essential for proper management. Health professional should have thorough knowledge regarding the complications related to AVF. Early diagnosis and appropriate treatment are essential to improve the quality of life in patients on HD.

Keywords: Arteriovenous, complications, dialysis, fistula, incidence, Taif


Hemodialysis (HD) is considered and accepted to be temporary treatment for patients with end stage renal disease (ESRD) awaiting renal transplantation. Repeated access to the circulation is essential to perform adequate maintenance HD.[1] Many patients who are not candidates for renal transplantation or those for whom a compatible donor cannot be secured are dependent on HD for their lifetime. This situation results in the long-term need for and use of dialysis access. There are a lot of short and long-term complications that may interfere with the functioning of the dialysis.[2]

The relative less availability of kidney donors and the increased survival of patients mean that most will require a prolonged period of artificial renal support, necessitating the formation of arteriovenous fistulas (AVFs). HD fistulas are surgically created communications between the native artery and vein in an extremity. AVF is an autologous arteriovenous access created by a connection of a vein to an artery (e.g. cephalic vein joined to radial artery) where the vein serves as the accessible conduit.[3]

Polytetrafluoroethylene (PTFE) and other materials (dacron, polyurethane, bovine vessels, saphenous veins) are used or have been used as a communication medium between the artery and the vein and are termed prosthetic HD access arteriovenous grafts (AVGs). The access that is created is routinely used for HD 2–5 times per week. Overall complication rates of AVFs are low typically, 0–16%. Complications include arterial emboli (1–7%); post–percutaneous transluminal angioplasty (PTA) flow-compromising ruptures (2–5%; the rate can be higher in native fistulas of upper arm [15%]); fluid overload or pulmonary edema; reactions to the contrast agent; extravasation hematomas at puncture sites of previous dialysis procedures; infection; and death (very rare). Death may result from cardiac arrhythmia, pulmonary edema, or a reaction to the contrast medium. Although clots may migrate into pulmonary circulation, clinically evident pulmonary embolism has been reported in only six cases; however, pulmonary embolism may occur with native fistulas. This complication is extremely rare during thrombolysis of HD access grafts.[4,5,6]

The Primary fistulas suggested in AVF include: (i) RCF, (ii) brachiocephalic fistula, (BCF) and (iii) basilic vein transposition (brachial-basilic) fistula. A major problem with AVFs is the high frequency of primary failures, either due to lack of maturation or early thrombosis. In cases of failure of an AVF created, secondary fistulas are constructed by utilizing the conversion of an arterialized outflow vein to a direct or transposed AVF.[7]

In some cases of diabetes mellitus (DM), heart failure, peripheral vascular disease, obesity or elderly patients, insertion of AVF is difficult or contraindicated.[8]

Studies have found that fistula complications are associated with morbidity, mortality, and a high economic burden.[9,10] And it was reported that early detection and treatment of these complications can prevent more severe conditions and consequently save additional costs and reduce hospitalization periods.[11]

In the Kingdom of Saudi Arabia, there is lack of data regarding the complications prevalent in patients who underwent AVFs. Hence, the main aim of this study was to measure the prevalence of AVF in patients on HD and its complications in patients undergoing HD with AVF in Taif Region, Saudi Arabia. The study also looked for any predisposing risk factors to the complications of AVF to prevent or minimize them in the future.

Subjects and Methods

This was a hospital-based prospective study done in 196 patients undergoing HD with AVF in two hospitals (King Abdulaziz Specialist Hospital and Prince Mansour Armed Forces Hospital in Taif city). The study was conducted during the period of December 2017 to December 2018. Data collection was carried out using a pretested questionnaire. The validity and internal consistency reliability of the questionnaire was measured. A Cronbach's alpha value of r = 0.854 was achieved.

All patients underwent detailed history taking, and data were collected on age, sex, and cardiovascular risk factors such as DM and hypertension (HTN). Patients were further evaluated using clinical examinations and reviewed by hospital records.

Inclusion criteria

All the patients who is undergoing HD with AVF and who gave consent to participate in the study. Participants were informed about the anonymity and confidentiality of the data/information they report in the questionnaire. Only people who aged above 18 years were included.

Exclusion criteria

Patients who did not give consent were excluded from our study. Also, patients treated or consulted in other departments and whose age was less than 18 years were also excluded from our study.

Ethical confederations

The Research Ethics Committee of Taif University approved the study ethical committee of Directorate of health affairs, ministry of health, Taif city on the 26th of June, 2018. Written and verbal consents were obtained from participant patients.

Data analysis

All the data collected were tabulated using MS Excel and statistical analysis was done using SPSS version 23. Descriptive statistics were used, with continuous variables expressed as mean ± SD and categorical data expressed as percentages. Pearson Chi-square test was applied to assess the statistical association of one variable with another. A P value of less 0.05 was considered statistically significant.


Our study was a cross-sectional 1-year prospective study which was done on 196 patients undergoing HD with AVF. The age wise distribution of participants is depicted in [Table 1].

Table 1

Distribution of participants according to age categories

Above 5011659.2

Open in a separate window

In our study, we included both genders, of which we had 49.5% males and 50.5% females. When the causes of doing dialysis were assessed, 49 (25%) patients did it because of renal failure, 47 (24%) did it due to “hypertension,” and DM was the cause for 6.6% of the patients. The detailed causes of dialysis are depicted in [Table 2].

Table 2

Distribution of the participants according to the causes of dialysis

After ophthalmic surgery10.5
After pregnancy21.0
Diabetes Mellitus136.6
Hypertension and Diabetes Mellitus63.1
Hypertension and Kidney failure10.5
Kidney atrophy126.1
Kidney failure4925.0
Recurrent infections10.5

Open in a separate window

According to the history of the prevalence of chronic illness among the participants, HTN was present in 79 (40.3%) and asthma was seen in 3 (3.6%.), 7 (1.5%) reported to have DM, 1 (0.5%) had hyperthyroidism, 1 (0.5%) had SLE, 60 (30.6%) participants reported that they had multiple illness, and 45 (23%) reported having no chronic illness.

Regarding the type of AVFs it was observed that RCF was seen in 64% of the patients, in which 45 had left RCF and 6 had right RCF. BCF was seen in 73 (37.2%) of the patients in which 51 had left and 22 had right BCFs. Brachiobasilic fistula (BBF) was present in 42 (21.4%) of the patients, of which 35 had left and 7 had right BBFs. The prevalence of brachiomedian antecubital fistulas (BAFs) was 5.6% (n = 11) in which 4 were left and 7 were right. The femoral and saphenous vein fistula (FSF) type was present in 6 (3.0%) patients and out of which 1 were left and 9 were right FSFs [Figure 1].

Open in a separate window

Distribution of AVFs according to type and side

In our study we found that 96.9% had dialysis three time/week, 2.0% had twice and only 1.0% reported having once in a week. The findings of the study show that 19 (9.7%) patients had bleeding from the AVF, whereas 27 (13.8%) patients had venous HTN due to AVF. The aneurysm at the site of AVF was seen in 49 (25%) patients. [Table 3].

Table 3

Distribution of the participants according to the history of complications (No.: 196)

ComplicationNo (No. (%)Yes No (%)Relationship with Smoking (p)Relationship chronic illness (p)
Bleeding from the AVF177 (90.3%)19 (9.7%)0.3110.876
Venous HTN169 (86.2%)27 (13.8%)0.6570.092
Aneurysm at the site of AVF147 (75%)49 (25%)0.7470.921
Ischemic Neuropathy138 (70.4%)58 (29.6%)0.5410.645
History of Heart Failure190 (96.9%)6 (3.1%)0.3150.447
History of lymphedema at the site of AVF193 (98.5%)3 (1.5%)0.416<0.001*
History of stenosis at the site of AVF157 (80.1%)39 (19.9%)0.3590.536
History of Myocardial Infarction190 (96.9%)6 (3.1%)0.037*0.928

Open in a separate window

The incidence of ischemic neuropathy was present in 58 (29.6%) patients and 6 (3.1%) patients had history of heart failure. The lymphedema at the site of AVF was present in 3 (1.5%) patients [Table 3]. When the relationship of history of complications with smoking status of patients was seen, it was found that there was no association observed, P > 0.05 except with patients who were smokers had history of myocardial infarction than non-smokers, P < 0.05 [Table 3].

When the relationship of type of AVFs with age of the patients were assessed, there was no possible association observed expect with femoral and saphenous vein fistula (FSF). Patients with FSFs had comparatively “right type” than “left type,” P < 0.001, [Table 4].

Table 4

Relationship between age of the studied patients and the type of AVF

VariableType of AVF
Above 5024836161832602
Pearson Chi-square value12.18919.04711.23220.56354.496

Open in a separate window

N.B.: R=Right; L=Left


HD is a temporary treatment for patients who are candidates for kidney transplantation and a permanent treatment for the ESRD patients with no chance of kidney transplantation.[12] In our study, most of the patients who had AVF were above the age of 40 years and the prevalence increased as the age increased. Complication related to AVF increases as the age increases and the management is usually very difficult.[13,14,15]

The most prevalent cause of dialysis in our study was found to be renal failure followed by hypertension. Researchers claim that occurrence of AVF insufficiency is mostly a result of pre-existing morphologic abnormalities due to the underlying disease such as renal failure or other causes. The findings showed that the prevalence of HTN alone was more (40.3%), followed by asthma alone (3.6%). About 30.6% of patients had multiple chronic illness. These findings support the findings of study done by (Codreanu et al., 2012).[16]

The most common complication seen in these patients was “ischemic neuropathy” (29.6%) followed by “aneurysm at the site of AVF” (25%). In a study done by Cavallaro et al., the most common complications reported were aneurysm followed by thrombosis.[17] Researches show that male gender was associated with an increased prevalence of HTN, microalbuminuria, and reduced renal function.[18,19] But, another study done by Nakagawa et al. reported that thrombosis with dysfunction of AVF was the most common complication (70.8%), while aneurysm occurred in 6.6% of the patients.[20] According to the published researches the important complications of fistulae are lymphedema, infection, aneurysm, stenosis, congestive heart failure, steal syndrome, ischemic neuropathy, and thrombosis.[21]

The choice of surgical technique for anastomosis has its own characteristics and it is a very important procedure to avoid certain surgical complications. End-to-end anastomosis requires a formidable surgical technique, especially when there is a discrepancy between the lumen of the arteries and veins. This can lead to ischemia of the distal extremities, especially in the elderly and patients with DM. Side-to-side anastomosis is technically easier and can be done if the blood vessels are close to each other. It must be noted that this type of anastomosis may lead to development of venous HTN. Currently, the most acceptable option is end-to-side anastomosis.[22,23,24] When considering the complications some of the preoperative factors that should be considered are the outflow vein diameter, arterial diameter and flow rate in the vein and across the anastomosis, all of could have an effect on the success of fistulas, especially in proximal and distal arm fistulas.[25]

Infections accounts about 20% of all AVF complications and most common infections inlcude perivascular cellulitis, which manifests as localized erythema and edema and is usually easily treated. Much more serious is an infection associated with anatomical abnormalities, such as aneurysms, hematomas or abscesses, which require surgical excision and drainage.[26]

In our study, ischemic neuropathy was seen in 16.1% of the patients and was common in diabetic patients. It is often manifested by weak arms, in the immediate preoperative period, severe pain, and paresthesia.[27]

Although risk factors are important, risk stratification schemes based on demographic and clinical parameters fail to accurately identify individuals in whom AVF placement is futile. The most important determinant in the success of an AVF is the quality of the available vessels (i.e. hemodynamic factors).[28] Individualization based upon pre-procedural vascular mapping is critical. As an example, an older black diabetic female with good vessels is a superior AVF candidate compared with a young white nondiabetic male with poor vessels. In a recent study done by Bae et al., it was suggested to undergo autologous AVF as the choice of vascular access in elderly HD (HD) patients.[29] Some studies revealed that the deaths in patients on HD are very minimal due to access-related problems, and mediation analyses indicated that vascular access complications were not able to adequately explain the association between access type and death.[30,31] No patient with ESRD should be excluded from consideration for an AVF without vascular mapping and evaluation by an experienced HD access vascular surgeon.


Knowledge about the potential complications of AVFs should contribute to their timely detection and allow measures to be taken that might prevent deleterious consequences that range from loss of vascular access to serious morbidity and may ultimately be fatal. Both the patient and professional should give utmost care for the AVF to reduce the complications. Early diagnosis and management of complications related to AVF is also essential to prevent loss of the vascular access.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


The authors express their gratitude to workers of the Kidney Centers at King Abdulaziz specialist hospital and Prince Mansour Hospital, Taif city, KSA. Special thanks to Dr. Nourah M. Alotaibi, Dr. Asalah H. alkhaldi, Dr. Waad D. Alotaibi, Dr. Nejoud F. Al-shreef, Dr. Maha N. alshreef, and Dr. Moshari N. Alhdili for their help in the data collection.


1. Kolff WJ, Berk HT. The artificial kidney: A dialyser with a great area. Acta Med Scand. 1944;117:121–31. [Google Scholar]

2. Rosas SE, Feldman HL. Synthetic vascular hemodialysis access versus native arteriovenous fistula: A costutility analysis. Ann Surg. 2012;255:181–6. [PMC free article] [PubMed] [Google Scholar]

3. Lee T, Mokrzycki M, Moist L, Maya I, Vazquez M, Lok CE, et al. Standardized definitions for hemodialysis vascular access. Semin Dial. 2011;24:515–24. [PMC free article] [PubMed] [Google Scholar]

4. Maya ID, Oser R, Saddekni S, Barker J, Allon M. Vascular access stenosis: Comparison of arteriovenous grafts and fistulas. Am J Kidney Dis. 2004;44:859–65. [PubMed] [Google Scholar]

5. Gomes A, Schmidt R, Wish J. Re-envisioning fistula first in a patient-centered culture. Clin J Am Soc Nephrol. 2013;8:1791–7. [PMC free article] [PubMed] [Google Scholar]

6. Santoro D, Benedetto F, Mondello P, Pipitò N, Barillà D, Spinelli F, et al. Vascular access for hemodialysis: Current perspectives. Int J Nephrol Renovasc Dis. 2014;7:281–94. [PMC free article] [PubMed] [Google Scholar]

7. Spergel LM, Ravani P, Asif A, Roy-Chaudhury P, Besarab A. Autogenous arteriovenous fistula options. J Nephrol. 2007;20:288–98. [PubMed] [Google Scholar]

8. Coli' L, Cuna V, Capelli I, Kwin C, Donati G, La Manna G, et al. When native arteriovenous fistula is not possible: The permanent catheter is better. G Ital Nefrol. 2009;26:154–7. [PubMed] [Google Scholar]

9. Manns B, Tonelli M, Yilmaz S, Lee H, Laupland K, Klarenbach S, et al. Establishment and maintenance of vascular access in incident hemodialysis patients: A prospective cost analysis. J Am Soc Nephrol. 2005;16:201–9. [PubMed] [Google Scholar]

10. Ravani P, Palmer SC, Oliver MJ, Quinn RR, MacRae JM, Tai DJ, et al. Associations between hemodialysis access type and clinical outcomes: A systematic review. J Am Soc Nephrol. 2013;24:465–73. [PMC free article] [PubMed] [Google Scholar]

11. Rosas SE, Feldman HL. Synthetic vascular hemodialysis access versus native arteriovenous fistula: A cost-utility analysis. Ann Surg. 2012;255:181–6. [PMC free article] [PubMed] [Google Scholar]

12. Gilpin V, Nichols WK. Vascular access for hemodialysis: Thrills and thrombosis. J Vasc Nurs. 2010;28:78–83. [PubMed] [Google Scholar]

13. Fan PY, Schwab SJ. Vascular access: Concepts for the 1990s. J Am Soc Nephrol. 1992;3:1–11. [PubMed] [Google Scholar]

14. Hakim RM, Himmerlfarb J. Haemodialysis access failure. A call to action. Kidney Int. 1998;54:1029–40. [PubMed] [Google Scholar]

15. Wali MA, Eid RA, Dewan M, Al-Homrany MA. Pre-existing histopathological changes in the cephalic vein of renal failure patients before arterio-venous fistula (AVF) construction. J Smooth Muscle Res. 2003;39:95–105. [PubMed] [Google Scholar]

16. Codreanu I, Sali V, Gaibu S, Suveica U, Popa S, Perico N, et al. Prevalence of hypertension and diabetes and coexistence of chronic kidney disease and cardiovascular risk in the population of the republic of moldova. Int J Hypertens. 2012;2012:951734–42. [PMC free article] [PubMed] [Google Scholar]

17. Cavallaro G, Taranto F, Cavallaro E, Quatra F. Vascular complications of native arterio-venous fistulas for hemodialysis: Role of microsurgery. Microsurgery. 2000;20:252–4. [PubMed] [Google Scholar]

18. Hsu CY, Iribarren C, McCulloch CE, Darbinian J, Go AS. Risk factors for end-stage renal disease: 25-year follow-up. Arch Intern Med. 2009;169:342–50. [PMC free article] [PubMed] [Google Scholar]

19. Guessous I, McClellan W, Vupputuri S, Wasse H. Low documentation of chronic kidney disease among high-risk patients in a managed care population: A retrospective cohort study. BMC Nephrology. 2009;16:25–35. [PMC free article] [PubMed] [Google Scholar]

20. Nakagawa Y, Ota K, Sato Y, Fuchinoue S, Teraoka S, Agishi T. Complications in blood access for hemodialysis. Artif Organs. 1994;18:283–8. [PubMed] [Google Scholar]

21. Stolic R. Most important chronic complications of arteriovenous fistulas for hemodialysis. Med Princ Pract. 2012;22:220–8. [PMC free article] [PubMed] [Google Scholar]

22. Allon M. Current management of vascular access. Clin J Am Soc Nephrol. 2007;2:786–800. [PubMed] [Google Scholar]

23. Scribner BH. Medical dilemmas: The old is new. Nat Med. 2002;8:1066–7. [PubMed] [Google Scholar]

24. Tordoir J, Canaud B, Haage P, Konner K, Basci A, Fouque D, et al. EBPG on vascular access. Nephrol Dial Transplant. 2007;22(suppl 2):ii88–117. [PubMed] [Google Scholar]

25. Pogula VR, Nalubolu MR, Byram R, Maddiboina H, Bodduluri S, Pavan AP, et al. Preoperative factors predicting the outcomes of arteriovenous fistula surgery. Indian J Vasc Endovasc Surg. 2019;6:74–8. [Google Scholar]

26. Saxena AK, Panhotra BR, Al-Mulhim AS. Vascular access related infections in hemodialysis patients. Saudi J Kidney Dis Transpl. 2005;16:46–51. [PubMed] [Google Scholar]

27. London GM. Left ventricular alterations and end-stage renal disease. Nephrol Dial Transplant. 2002;17:29–36. [PubMed] [Google Scholar]

28. Beathard GA. Complications of vascular access. In: Lameire N, Mehta R, editors. Complications of Dialysis. New York: Marcel Dekker; 2000. p. 1. [Google Scholar]

29. Bae E, Lee H, Kim DK. Autologous arteriovenous fistula is associated with superior outcomes in elderly hemodialysis patients. BMC Nephrol. 2018;19:306–19. [PMC free article] [PubMed] [Google Scholar]

30. Ravani P, Quinn R, Oliver M. Examining the association between hemodialysis access type and mortality: The role of access complications. Clin J Am Soc Nephrol. 2017;12:955–64. [PMC free article] [PubMed] [Google Scholar]

31. Quinn RR, Oliver MJ, Devoe D. The effect of predialysis fistula attempt on risk of all-cause and access-related death. J Am Soc Nephrol. 2017;28:613–20. [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Family Medicine and Primary Care are provided here courtesy of Wolters Kluwer -- Medknow Publications

Complications of arteriovenous fistula in dialysis patients: Incidence and risk factors in Taif city, KSA (2024)


What is the most common complication of AV fistula for dialysis patients? ›

The most common type of AVF was radiocephalic fistula (RCF). The most common complication associated with the patients with AVF was ischemic neuropathy (29.6%).

What is the mortality rate for arteriovenous fistula? ›

Dural arteriovenous fistula survival rate

Current studies report that the annual mortality rate (the number of people who die due to this condition) is between 11% and 19%.

What are the risk factors for AV fistula thrombosis? ›

Predictors of Primary Failure

Patient factors that predict primary failure include age, sex, race, diabetes, history of coronary artery disease, peripheral vascular disease, obesity, and location of the fistula.

What is the most common cause of arteriovenous fistula failure? ›

Thrombosis is the leading cause for primary failure of AVF. It is also the leading cause of permanent access loss. Access thrombosis accounts for 65% to 85% of cases of permanent access loss [8].

What is the risk of arteriovenous fistula? ›

An arteriovenous fistula in the legs can cause blood clots to form. Leg blood clots may lead to a condition called deep vein thrombosis (DVT). deep vein thrombosis (DVT) can be life-threatening if the clot travels to the lungs (pulmonary embolism). Depending on where the fistula is, it may lead to a stroke.

What is the most serious complication of dialysis? ›

Fluid overload.

Since fluid is removed from your body during hemodialysis, drinking more fluids than recommended between hemodialysis treatments may cause life-threatening complications, such as heart failure or fluid accumulation in your lungs (pulmonary edema).

Can a dialysis fistula be removed? ›

Removal of Noninfected Arteriovenous Fistulae after Kidney Transplantation is a Safe and Beneficial Management Strategy for Unused Dialysis Access.

How often do AV fistulas fail? ›

It is for this reason that these guidelines and the Fistula First project recommend AVF creation in a majority of patients. However, a significant number of fistulae (28 to 53%) fail to mature adequately to support dialysis therapy (2 6).

What is the recovery time for an arteriovenous fistula? ›

Arteriovenous fistulas can take between 6-12 weeks to mature and arteriovenous grafts can generally be used 2-3 weeks after surgery.

What is the main disadvantage of an AV fistula? ›

– AV fistulas may not be suitable for people with small or weak veins. – The most common problem with the AV fistula is stenosis, the narrowing of the blood vessel, which may lead to a decrease in blood flow or formation of blood clots. – Strengthening the AV fistula requires daily exercises.

Which condition is at the highest risk for fistula formation? ›

A history of trauma, inflammatory bowel disease, and oncologic surgery places patients at a high risk of developing a fistula.

How does an arteriovenous fistula affect the heart? ›

When a large proportion of arterial blood is shunted from the left-sided circulation to the right-sided circulation via the fistula, the increase in preload can lead to increased cardiac output. Over time, the demands of an increased workload may lead to cardiac hypertrophy and eventual heart failure.

How do you unclog a fistula? ›

When fistulas and grafts become clogged or narrowed, preventing a patient from undergoing dialysis, interventional radiologists use image-guided interventions to fix the problem, such as: Catheter-directed thrombolysis, which dissolves blood clots that build up in fistulas and grafts by injecting a medicine.

What happens when dialysis fistula fails? ›

If your access is not working well, it can decrease the amount of fluid and toxin removal your dialysis treatment achieves. This, in turn, can affect your overall health and how you feel. If you suspect there's a problem with your fistula, notify your dialysis care team right away.

What is the cost of dialysis fistula surgery? ›

Cost Of Different Types Of AV Fistula surgery in India
Type of treatmentAverage CostMaximum Cost
Simple AV Fistula Surgery₹35,000₹50,000
Radiocephalic AV Fistula Surgery₹72,000₹100,000
Brachiocephalic AV Fistula Surgery₹100,000₹150,000
Basilic Vein Transposition AV Fistula Surgery₹135,000₹200,000
4 more rows

How serious is a fistula for dialysis? ›

A fistula formation is generally a very safe operation. The most common complication is that the fistula doesn't mature. Approximately 30% of fistulas will not work either within the first 24 hours or so after the operation, or they will clot off or fail to develop suitably to be used for haemodialysis.

What are the symptoms of a traumatic arteriovenous fistula? ›

The presenting symptoms depend on the size of the fistula. The patient may note a pulsating mass or a thrill in the region of previous penetrating trauma. Large extremity fistulas may have the warmth of overlying skin, which contrasts with distal coolness.

Is AV fistula painful for dialysis patients? ›

How is the AV fistula procedure performed? A surgeon usually performs the procedure in the operating room. You receive a local anesthetic (numbing medicine) at the proposed site along with IV sedation to relax you. Discomfort is minimal and you may even fall asleep during the 1 to 2 hour-long procedure.

Top Articles
Latest Posts
Article information

Author: Corie Satterfield

Last Updated:

Views: 5312

Rating: 4.1 / 5 (42 voted)

Reviews: 89% of readers found this page helpful

Author information

Name: Corie Satterfield

Birthday: 1992-08-19

Address: 850 Benjamin Bridge, Dickinsonchester, CO 68572-0542

Phone: +26813599986666

Job: Sales Manager

Hobby: Table tennis, Soapmaking, Flower arranging, amateur radio, Rock climbing, scrapbook, Horseback riding

Introduction: My name is Corie Satterfield, I am a fancy, perfect, spotless, quaint, fantastic, funny, lucky person who loves writing and wants to share my knowledge and understanding with you.