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What to Do If My Dialysis Fistula Closes?

In this blog, Dr. Kaurabhi Zade, a Vascular and Interventional Radiologist at Sahyadri Hospital, Pune, sheds light on the critical issue of dialysis fistula closure. For patients with kidney failure, the dialysis fistula serves as a vital lifeline, enabling them to undergo dialysis two to three times a week. However, when this fistula becomes occluded, many questions arise regarding treatment options.

What Happens When a Dialysis Fistula Closes?

A dialysis fistula is essential for patients with kidney failure as it allows for efficient dialysis treatment. When a fistula closes, it is crucial to understand the implications and necessary actions. Patients often wonder if the fistula can be treated, if they need to undergo dialysis through a catheter, or if a new fistula must be created. Receiving timely guidance on this matter is essential.

The Importance of Timely Intervention

If your dialysis fistula has closed, immediate consultation with your doctor or vascular specialist is critical. Timely intervention can potentially save the fistula. The number of sites available for creating a fistula is limited; typically, two to four sites can be utilized. Once these sites are exhausted, preserving existing access becomes paramount.

Treating Blockages in the Fistula

In cases where the fistula is closing due to a small blood clot or blockage, it can often be treated using angioplasty with a small needle. This procedure is similar to treating blocked coronary arteries during heart attacks, which often involves placing a stent. However, not every patient requires a stent; sometimes, a simple balloon angioplasty can effectively clear the blockage and restore function to the fistula.

The Risks of Delayed Treatment

Delaying treatment by waiting two or three months after noticing an issue with the fistula can lead to irreversible damage. Therefore, if your fistula is not functioning, seek immediate attention from your vascular specialist. Quick treatment can help salvage the fistula and restore proper function.

Alternative Solutions When Fistula Creation is Not Possible

In situations where creating a new fistula is not an option due to a lack of viable veins, doctors may resort to inserting a catheter into the neck, creating a tunnel for dialysis access, referred to as a “Permcath.” This option can provide dialysis access for two to three years, provided there are no infections.

Conclusion: Take Action Promptly

If your dialysis fistula is not working, the most important action is to consult your doctor promptly. If there is a blood clot or blockage, quick treatment can be administered. Remember, waiting too long – beyond the crucial 10 to 15-day window – may lead to permanent damage to the fistula.

For more information on this topic or to seek advice, feel free to contact  Dr. Kaurabhi Zade. Thank you for reading, and take care of your health!

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Dr. Sajal Kamat

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