Dialysis Access

For patients requiring haemodialysis, having reliable vascular access is essential. Dr. Medani creates arteriovenous (AV) fistulas — the preferred form of dialysis access — and manages AV grafts, ensuring long-term, dependable access for treatment.

Symptoms to Watch For

  • Approaching need for haemodialysis (advancing chronic kidney disease)
  • Problems with existing dialysis access (poor flow, clotting, infection)
  • Swelling of the arm containing a fistula or graft
  • Difficulty with dialysis sessions (alarms, poor clearance)
  • Pain or redness around dialysis access site
  • Aneurysm formation at the fistula site

How Dr. Medani Treats This

1

Arteriovenous (AV) Fistula Creation — The preferred form of dialysis access. Dr. Medani surgically connects an artery to a vein, usually in the forearm or upper arm, creating a high-flow access point that matures over 6-8 weeks.

2

AV Graft Placement — When a native fistula is not possible, a synthetic graft is used to connect an artery to a vein, providing reliable dialysis access.

3

Fistula Salvage & Revision — For existing fistulas that are not functioning well, Dr. Medani performs interventions to restore flow and extend the life of the access.

4

Central Venous Catheter — Temporary dialysis access through a catheter in the neck or chest, used when urgent dialysis is needed before a fistula has matured.

5

Pre-operative Vein Mapping — Duplex ultrasound to assess the quality and size of veins and arteries before creating dialysis access, ensuring the best possible outcome.

What to Expect

Planning

Dr. Medani will perform vein mapping using duplex ultrasound to identify the best vessels for fistula creation. Planning well in advance of needing dialysis gives the best results.

Surgery

AV fistula creation is typically performed as a day-case procedure under local or regional anaesthesia. The surgery takes 1-2 hours.

Maturation

After surgery, the fistula needs 6-8 weeks to mature before it can be used for dialysis. Dr. Medani will monitor its development with regular assessments.

Ongoing Care

Regular follow-up to monitor fistula function. Early detection of problems allows timely intervention to maintain reliable access.

Frequently Asked Questions

Why is an AV fistula preferred over other types of dialysis access?
AV fistulas have the lowest rates of infection, last the longest, and require the fewest interventions compared to grafts and catheters. International guidelines recommend fistulas as the first choice for haemodialysis access.
When should I see a vascular surgeon about dialysis access?
Ideally, patients should be referred for access planning when their kidney function falls to a level suggesting dialysis may be needed within 6-12 months. Early planning allows time for fistula creation and maturation.
What if my fistula stops working?
Fistula problems can often be corrected with minimally invasive interventions (angioplasty) or surgical revision. Prompt evaluation is important — contact Dr. Medani if you notice changes in your fistula's thrill (vibration) or if dialysis sessions become difficult.
Can I use my fistula arm normally?
You can use the arm for most normal activities. Avoid heavy lifting with the fistula arm immediately after surgery. Do not allow blood draws or blood pressure measurement on the fistula arm. Dr. Medani will provide detailed care instructions.

Book a Consultation for Dialysis Access

Schedule a consultation with Dr. Medani to discuss your condition and learn about the treatment options available to you.

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