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Haemodialysis and

                                                                             Peritoneal Dialysis
                                                                              – A Guide for Patients




        RISKS OF AV FISTULA
        OR GRAFT
           Not every fistula or graft
        will work first time. The
        success with a fistula is about
        70%. Some patients have to
        come back to have a new fistula
        made a second or third time.
           Occasionally, when a fistula
        is made it takes too much blood
        from the hand, resulting in
        what's called ‘steal syndrome’. If
        this happens, it may require that
        the fistula be reversed and
        another access created for
        dialysis.
           A graft may be prone to
        developing an infection. If this
        does develop, you will require a
        prolonged period of IV antibiotics.                         A patient receives dialysis treatment using an
           Occasionally, a fistula or graft will clot and it will             anteriovenous fistula.
        not be possible to use for dialysis. If this occurs it   must be washed well up to the elbow with
        may be necessary for the surgeon to remove the           Hibiscrub (pink solution), which is located at all
        clot to ensure your access functions again.              sinks within the dialysis unit.
                                                              l Should you develop any signs of infection such
        Care for Fistulas and Grafts                             as redness, swelling, pain, tenderness or
           The following information is important to             discharge from your fistula, contact your dialysis
        remember in order to ensure your fistula stays           unit immediately.
        working for the longest time possible.                l You will be shown how to assess your fistula. If
        l Do not wear constrictive clothing or watch             you notice the buzz is gone, contact the unit
           straps on the fistula arm.                            immediately.
        l Avoid trauma to the fistula arm, such as cuts and   l Do not sleep with your access arm under your
           abrasions.                                            head or body.
        l Do not allow anyone to take blood samples,          l Do not lift heavy objects or put pressure on your
           blood pressure readings or insert an IV cannula       access arm.
           (drip) into your fistula arm.                      l Learn how to properly hold the gauze after the
        l Avoid dehydration. This may occur if you lose          dialysis needles are removed. If your fistula
           excessive amounts of fluid (for example, if you       starts bleeding, apply pressure to the fistula site
           develop diarrhoea or are unwell and unable to         until bleeding stops and contact your unit
           drink your fluid allowance).                          immediately.
        l Maintain a high standard of hygiene. It is          l To ensure safety, during your dialysis treatment,
           preferable to have a daily shower. Before and         your fistula should be in view of nursing staff at
           after your dialysis treatment, your fistula arm       all times.

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