A-V Fistula surgery (chronic kidney disease)

A-V Fistula surgery (chronic kidney disease)

Home >A-V Fistula surgery (chronic kidney disease)

Chronic kidney disease patient requires long term hemodialysis to get rid of impurities, which are usually eliminated by normal functioning kidney. A-V fistula surgery is an important life boat that ease the procedure of hemodialysis to significant extend and also minimizes the chances of infection. Our chief plastic surgeon, Dr. Ujwal Chirde, performs a detailed assessment of the patient proposed for A-V fistula surgery which maximizes the chances of a successful outcome.

A-V Fistula surgery is emerging as a promising treatment option for individuals suffering from chronic kidney disease (CKD). This surgical procedure creates a connection between an artery and a vein, allowing for efficient hemodialysis treatment. In Pune, skilled surgeons are performing A-V Fistula surgeries with precision, providing hope to CKD patients.

Chronic kidney disease is a progressive condition that affects the kidneys’ ability to filter waste and excess fluids from the blood. Hemodialysis, a process where blood is purified using a machine, becomes necessary in the advanced stages of CKD. A-V Fistula surgery plays a crucial role in facilitating this procedure by creating a reliable access point for dialysis treatments.

A-V Fistula Surgery Treatment 

  • A-V Fistula surgery is a treatment for chronic kidney disease (CKD) patients requiring hemodialysis.
  • The surgery involves creating a connection between an artery and a vein in the arm.
  • This connection, known as a fistula, enables reliable access for hemodialysis.
  • The surgery allows high-pressure arterial blood to flow into the vein, enlarging it for repeated needle insertions during dialysis.
  • A-V fistula surgery requires 2 to 3 months for the fistula to mature before it can be used for hemodialysis.
  • The long-term viability of A-V fistula reduces the risk of infection, clotting, and other complications.
  • Patients undergo a thorough evaluation before the surgery to assess their overall health and suitability.
  • Regular follow-up visits are necessary after the surgery to monitor healing and detect any complications.
  • A-V fistula surgery offers a promising solution for improving the quality of life for CKD patients requiring hemodialysis.

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What is A-V fistula surgery?

Patient with chronic kidney disease requires frequent hemodialysis for long period of time. A-V fistula surgery involves surgical establishment of connection between blood vessels (artery & vein). This increases the rate of blood flow through the vein which can be safely and effectively used for the procedure of hemodialysis.


Preliminary consultation involves detailed clinical assessment of the patient. If needed you might be advised doppler ultrasound of the upper limb (usually non-dominant limb) for the further evaluation. Patient is expected to follow below precautions before surgery:

  • Refrain from blood collection, needle prick, intravenous medications through the limb proposed for the surgery.
  • Avoid application of blood pressure measuring cuff to the arm.
  • Soft ball squeezing exercises should be started for the surgery limb. This improves the size of blood vessels.
  • Avoid wearing tight cloth, bangles, ring, watch and jewelry in the proposed surgery limb.
  • Stop blood thinner 5 days prior to surgery with proper consultation with your doctor.

Don’t forget to take your anti-hypertensive medication on the day of surgery.

  • Surgery is usually performed under local anaesthesia. Patient is expected to lay down on their back during the procedure. Surgery lasts for about one and half to two hours. You must inform your doctor beforehand, if you are having difficulty in laying down.

A-V fistula surgery increases the rate of blood flow through the vein, which thickens the blood vessel wall. This process of the vessel maturation usually takes 6 to 8 weeks post-surgery. During this period patient is instructed to feel the pulsation at newly created fistula site daily, as advised by the doctor. You should consult the doctor immediately if there is any change in pulsation. Matured vessel can be used for hemodialysis only after 6 to 8 weeks.

You should consult your doctor immediately if there is:

  • Failure of fistula
  • Bleeding from the operated site
  • Swelling of limb
  • Change in color or ulceration of the finger tip
  • Limb elevation by keeping couple of pillows beneath the operated limb. It helps to resolve the swelling.
  • Soft ball exercises should be started from the very next day.
  • Patient should resume all the pre-operative medications.
  • Avoid lifting heavy object by the operated limb.
  • Operated site should be well protected from any external injury. Patient is advised to wear a wrist band.
  • A brief antibiotic course is given to avoid any infection at the operated site
  • Patient is prescribed Tab. Ecosprin for one week post- surgery.
  • Refrain from blood collection, intravenous medication; application of blood pressure cuff, wearing tight clothing & jewelry on the operated limb.

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