More than 2.5 million people rely on hemodialysis worldwide. Hemodialysis makes waste removal along with excess fluids possible if your kidneys fail. However, for the process to be performed correctly, reliable vascular access must exist. Doctors create mainly three types of vascular access for dialysis in patients. These include an arteriovenous fistula, an AV graft, or a Vascular Tunneled Central Catheter Access.
The arteriovenous (AV) fistula is the preferred type because it provides long-term access while causing fewer complications than catheters or grafts. However, you must go for a routine follow-up assessment of the fistula to maintain its health and prevent complications such as thrombosis or infection. This proactive approach extends the fistula’s life span and allows for more effective dialysis results.
So, read on to learn more about why regular fistula checks are essential and the consequences of skipping them.
Why Fistula Monitoring Matters
When taken care of properly, AV fistulas can last longer without requiring any additional procedures to sustain them for long-term dialysis. Thus, you should regularly monitor the health of AV fistula as it offers the following additional benefits:
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Spotting Problems Early
Even though fistulas are durable, they are not completely immune to conditions or infections. When you keep a close eye on your fistula, you can easily catch the following early signs relating to an issue:
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Stenosis (Narrowing)
Stenosis can reduce blood flow and make dialysis less effective. It may appear repeatedly during the dialysis. Normally, dialysis should be run with a speed of at least 300ml/min. However, stenosis can cause the dialysis technicians to reduce the flow or speed of the dialysis to avoid strain on the access site.
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Infections
Infections can also occur at the access site. When it is left untreated, you may experience severe health complications. Infections appear with symptoms such as redness, warmth, swelling, or discharge at the site and fever during dialysis.
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Thrombosis (Clotting)
Blood clots also form at the access site and block the smooth blood flow. This stops the fistula or graft from working and makes dialysis impossible until the issue is fixed. When you go for regular screenings, and the doctor makes early interventions, like using blood thinners or minor surgeries, you can prevent clots from forming.
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Prolonged Bleeding
If bleeding takes longer than usual to stop after dialysis needles are removed, it might mean there’s a blockage deeper in the blood vessel. This blockage can increase pressure in the access site, causing bleeding issues. Talk to your healthcare team if you notice prolonged bleeding, as this could be a sign of stenosis or another problem that needs attention.
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Ensuring Dialysis Works Efficiently
For dialysis to work well, your fistula needs to function properly. It should allow blood to flow smoothly so that toxins and waste are removed effectively during treatment. Here’s what regular checks help with:
- Proper Blood Flow: The blood flow in your fistula should be at least 600 mL/min. This allows the dialysis machine to maintain a treatment flow rate of 300 mL/min or higher without triggering flow alarms.
- Open and Accessible Fistula: The fistula should remain open and easy to access for needle insertion.
When your fistula is working as it should, dialysis sessions are more effective, which makes treatments less stressful.
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Extending the Life of Your Fistula
With routine assessments and timely maintenance, you extend the life of your fistula for many years. Addressing issues early, like fixing narrowing, can prevent the need for surgical repairs or replacements. Since fistulas are often the best option for vascular access, preserving them is critical.
What Happens During a Fistula Check?
When you arrive at the clinic or our Vascular Access Camp, you can expect the following steps followed by the healthcare professional to conduct a thorough fistula check:
- Physical Exam: Your healthcare provider will look for signs of swelling, redness, or bulges (such as aneurysms).
- Listening to Blood Flow: With the help of a stethoscope, they’ll check for the “thrill” or “bruit,” the vibration and sound that indicate good blood flow.
- Imaging Tests: If any issues are suspected, they may use tools like ultrasounds or angiograms to examine any issues more closely.
- Self-Checks: Patients are encouraged to monitor their fistula daily for signs of trouble, such as changes in the thrill or unusual swelling.
Why Self-Checks Are Important
You have a huge role in keeping your fistula healthy. All you have to do is perform daily self-checks. You can consider the following points for keeping your self-monitoring accurate:
- Feel the Thrill: Lightly place your fingers on the fistula. You need to feel a steady vibration that indicates blood is flowing properly.
- Look for Redness or Swelling: Look for any unusual appearance around your fistula. These could be signs of infection.
- Note Any Changes: If the fistula feels different, such as becoming harder, softer, or larger, you need to contact your doctor immediately.
These simple steps take just a few seconds but can help you catch potential problems early and get medical attention quickly.
What Happens If You Skip Regular Checks?
An AV fistula is more of an intentionally created opening, which needs poorer care and checks from your end. Neglecting this fistula care can lead to serious complications, such as:
- Access Failure: Narrowing or clots will block the fistula, which may further require you to undergo a surgical intervention.
- Dialysis Disruptions: A non-functional fistula can delay or interrupt treatments that will put your health at risk.
- Infections: Untreated infections can spread to other healthy tissues and cause severe health problems, which may even require you to be hospitalized.
Regular monitoring helps you avoid these risks. These preventive measures keep your treatments on track and your fistula working well.
Take Preventive Measures and Keep Your Fitula Healthy!
Regular fistula checks are one of the most important steps in successful dialysis care. They help catch problems early, keep treatments running smoothly, and extend the life of this critical access point. With routine doctor visits and daily self-checks, you can take an active role in protecting your fistula and ensuring your health.
Spending a few moments every day checking your fistula and keeping up with routine medical assessments will avoid larger complications later on. It’s a small act but can have a huge impact on your life.
Frequently Asked Questions
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How often should my fistula be checked by a doctor?
Every time you go to dialysis, a dialysis technician will check your fistula. If the doctor thinks it’s necessary, they may also suggest additional examinations such as ultrasounds or angiograms. These examinations help in the early detection of narrowing arteries or low blood flow circumferences and help keep the fistula healthy.
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What’s the best way to do a self-check?
Feel for the “thrill” (a vibration or buzzing sensation) on daily use. Look out for redness, swelling, or change in size or texture around the fistula site. Report any unusual findings to your healthcare provider immediately to prevent complications.
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What should I do if the thrill is weak or gone?
Call your healthcare provider right away. A weak or absent thrill may indicate blockage or reduced blood flow in the fistula. This can be handled early to prevent the need for larger treatments.
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Can regular checks prevent surgery?
Yes, these could be identified by regular checks, earlier narrowing, or minor clots. Non-invasive procedures such as fistulograms or angiography can perform the work in most cases instead of resorting to surgery, keeping the fistula functional and eliminating surgery.
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Are imaging tests necessary every time?
No, imaging like ultrasound or angiogram is not always necessary. The doctor recommends it only when something is found wrong through physical examination, or you experience some troubling symptoms.
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What are warning signs that my fistula might be failing?
Monitor for recurrent alarms with dialysis, such as swelling, redness, pain, loss of thrill, or protracted bleeding after dialysis. These may be signs of decreased blood flow or impending thrombosis. Call your doctor right away if you experience any of these symptoms.
