Dialysis Access Surgery in Ranchi

Dialysis access surgery creates or maintains a reliable blood-flow access for haemodialysis. The preferred long-term option is often an arteriovenous fistula (AV fistula), where an artery and vein are surgically connected.

• Advanced chronic kidney disease expected to need haemodialysis.
• Patients already on dialysis using a temporary catheter.
• Failed or poorly functioning previous AV fistula.
• Need for AV graft when suitable veins are unavailable.
• Access-related swelling, thrombosis or poor flow requiring revision.

Clinical examination and Doppler ultrasound may be used to assess vein size, arterial flow and the most suitable site for fistula creation.

An AV fistula usually needs time to enlarge and strengthen before routine dialysis cannulation. The maturation period varies and should be assessed clinically or by Doppler when needed.

• Check for the vibration or “thrill” daily.
• Avoid blood pressure measurements on the fistula arm.
• Avoid tight clothing or prolonged pressure over the access.
• Report sudden loss of thrill, swelling, pain or bleeding.
• Maintain skin hygiene before dialysis.

Possible complications include bleeding, infection, thrombosis, poor maturation, venous narrowing, arm swelling, steal syndrome and aneurysmal change in the access.