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The Care of Dialysis Fistulas

Dialysis is a procedure done when a patient’s kidneys can no longer function on their own. Several times a week, the patient will go for a dialysis treatment where they will be hooked up to a dialysis machine via their fistula to clean their blood from impurities to keep them alive. Proper care of the fistula is important to avoid infection and keep it functioning properly.

  1. Definition

    • A fistula is the access area a kidney doctor makes in a patient's arm by joining an artery and a vein during surgery to prepare for dialysis. During a dialysis treatment, the patient’s blood moves out of their body through the fistula into the machine where it will be cleaned of waste products just as their kidney would do if it were functioning properly. The clean blood moves back into the body through the fistula.

      After fistula surgery the patients vein will start to increase in size and become strong enough for it to be used as the access point in the dialysis treatment. The fistula starts to look like a bunchy rope underneath the skin on the patient's arm. The access point is the opening in your skin where the dialysis needles will be inserted. The access site is changed every two or three weeks.

    Healthy Vibration

    • Protect and care for your fistula so that it will not fail; if it fails you will have to have use another method of access for dialysis which may not be as effective.

      Your fistula will vibrate through out the day when it is functioning properly. Check a few times a day for this vibration called a “thrill”. If you stop feeling the vibration, call your doctor as this may mean there is a blood clot. If you catch the blood clot early, chances are better that it can be resolved.

    Daily Care

    • Watch for bleeding after your dialysis, if the access site seems red, or bleeds longer than normal, call your doctor.

      Take care of the arm that the fistula is in by not sleeping on it. Do not wear jewelry such as tight bracelets on that arm. Avoid carrying heavy items that will press on your fistula or injure your access point. Do not wear tight clothing that will restrict blood flow to your arm. Do not have blood pressure taken from your fistula arm.

    Cleaning the Fistula

    • Keep your access point on the fistula clean. Wash the access site each day with an antibacterial soap, especially before your dialysis session. Do not use lotion or cream on your access site. Do not touch, pick at or scratch the fistula access site.

      Check for infection by looking for redness, swelling, pimples or boils. Call your doctor if you think you have an infection or any pain in the area, and he can prescribe antibiotics.

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