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Kidney Disease

                                                                                — Haemodialysis and
                                                                    Peritoneal Dialysis Explained

           The fistula is usually placed in the forearm. AV
        fistulas may also be placed in the upper arm, if a
        previous AV fistula has failed or if the arteries or
        veins in the forearm are unsuitable for the creation
        of a fistula. It is preferred that the fistula be placed
        on the ‘non-dominant’ arm or the arm that you do
        not use as frequently.
           8-12 weeks is usually needed to allow the
        fistula to properly develop, although it may
        take longer in some cases. Once the fistula has
        developed, you are ready to commence
        haemodialysis treatment.
           A nurse will insert two needles into the fistula,
        one for withdrawing blood from the body and the
        other to return dialysed or filtered blood to the
           Not everyone is suitable for an AV fistula. It can
        be difficult to create, in some patients, due to small
        veins and other conditions. Your surgeon may order
        a test to show the blood flow in your arms, to
        determine if you are suitable for a fistula.

                “Not everyone is suitable
               for an AV fistula. It can be
          difficult to create in some patients
              due to small veins and other


                                                                            Upper arm primary fistula


          PROS                                                                        CONS
          l  Best overall dialysis performance                       l   Visible on the forearm
          l  Considered the best vascular access                  l   May take time to develop
          l  Less chance of infection than other                   l   May require temporary access while
               types of access                                                            fistula matures
          l  Tend to last many years                                       l   May bleed after dialysis needles are removed
          l  Predictable performance                                      l   Some fistulas may fail to mature
                                                                                                l   Steal Syndrome - Poor circulation

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