AV Fistula is created in the dominant arm of the patient. This AV Fistula site is where the blood can flow in and out of the body during the dialysis treatments. This is called dialysis access. Preparation for hemodialysis may begin six months or more, in advance of your first treatment. This time is needed to have a dialysis access placed in the arm by a vascular surgeon. The surgical access takes time to heal or mature, before it can be used. In some cases, the surgeon will plan for a two stage surgical procedure.
It is suggested that when AV Fistula operation is done and the site has matured (ghaa shukiye jawar pore), the patient should use a soft ball and press it as many times possible during the (may be upto 500 to 1000 times). This bulges the veins of the arm. When dialysis technicians insert needles to perform dialysis, the bulged veins enable easier insertion of needles.
Three types of accesses:
Arteriovenous Fistula (AVF). A surgically created connection between an artery and a vein, usually in your non dominant arm. This is the preferred type of access because of effectiveness and safety. However it may take several months for the fistula to form or mature.
Arteriovenous Graft (AVG). If your blood vessels are too small or not available, then the surgeon may use a synthetic material, a graft, to connect your artery to vein. A graft access can be used within a week or two, but is more prone to infection and clotting. In general, a graft access will not last as long as a fistula.
Central Venous Catheter (CVC). This is usually used if you need emergency hemodialysis. It is also used as a temporary access when AVF or AVG is not yet available. It is a synthetic tube that is inserted into a large neck vein, and protruded from below the collarbone. It may also be placed in the groin. The catheter is also prone to infection and blockages.