Anga AVF Centre

Why dialysis needs vascular access

Patients with end stage kidney disease need either peritoneal or haemo (blood) dialysis to remove waste products & water from their blood.

Most patients are prepared for haemodialysis. In haemodialysis, blood is drawn from the patient & passed through a machine which removes the waste products & water. The "purified" blood is then returned to the patient.

What is an AV fistula?

To facilitate this process, an Arteriovenous Fistula (AVF) is done. An AV fistula is a communication between an artery and a vein that allows blood to flow from the artery directly into the adjacent vein.

Where the fistula is placed

An AV fistula may be located:

• near the wrist or forearm (called a radiocephalic fistula)
• near the elbow or upper arm (called the brachiocephalic fistula)

Timing: why earlier is better

AVF needs time to mature & thus it is best to do this procedure 4-6 months before the start of dialysis. The success/flow rate of the operation is dependant on the size & normality of the artery & vein and a good anastomosis.

If dialysis is needed immediately

For immediate dialysis the nephrologist inserts a catherter in the vein of the neck or groin. This is done for patients who need immediate dialysis, while waiting for the AVF to mature.

When a fistula isn't suitable: prosthetic graft

Prosthetic graft is an option for patients with superficial veins not suitable for AVF.

What happens next

1. Get a referral. Most patients are referred to Anga AVF Centre by their nephrologist. Call or WhatsApp us to arrange your first appointment.
2. Consultation and vein check. At your first visit, the surgeon examines your arm and checks your veins and arteries to decide where the fistula can be placed.
3. Surgery and maturation. The surgeon joins an artery and a vein in your arm. Your dialysis unit begins using the fistula once your care team confirms it has matured.