Was your fistula placed prior to dialysis - at what % and how long before?

[ODAT]

Here I am again with my many questions. We found out today that mom can't have her knee surgery on 2/12 because the cardio doc wants her on Plavix for 6 months straight. She would have to stop taking Plavix two weeks prior and four weeks post of surgery. And, seeing that mom doesn't want to bother with fistula until she has fully recovered from knee surgery, that is getting pushed down the road too.

My question is have any of you been in this position - kidney doc says dialysis in about a year - how soon did you get the fistula placed? My mom's numbers were good today (don't know exact because sister took her) and the cardio said he didn't think there was an urgency. I also have a concern for the fistula placement of her being on Plavix. We are going ahead with the consult with vascular surgeon next Wednesday where I'll ask him these same questions. I'm just bracing for the possibility that he tells us her veins are too small (or whatever) to do a fistula. I've seen on here that people have pushed for them to do it anyways and were successful.

Mom's skin has finally healed. She said when she made her bed it looked like it was snowing! (I know...TMI).  (I don't use the smileys too often - one of the users that does the cutest ones is goofynina!)

[kellyt]

Hi ODAT.  In August my nephrologist told me that he suspected I'd be on dialysis in about 1 year.  He had my 1st fistula placed at the end of Sept.  That one didn't work, so I had #2 done on Oct. 31st.  He said it would take about six months before it could be used.  I'm hoping to transplant before having to start dialysis.  Crossing my fingers and toes!  Good luck to your mother.

[Black]

Mike had the original fistula surgery a year before.  I think he was around 12 to 15% but really can't remember for sure.  Seven weeks before, he had collateral arteries tied off and the vein raised closer to the surface.

[RichardMEL]

It ended up that mine was put in 2 years before I needed it (hooray) which meant it was nice and strong and "mature"by that time.  I see some folks who have just had fistulas put in like 4 weeks before and they sometimes don't work because they're not strong enough so I'd say if you know dialysis is down the track.. get it done that way you can build it up and get it strong so when the time comes your fistula can handle it.

[paris]

I was told over 2 years ago that I would be on dialysis in six months.  I am at 15% and have been for months.  My neph continues to be amazed that I have done so well. No fistula--neph thinks PD is for me and I think I agree.  Once I got over the initial reaction of the 6 month scare, I took control of my life and enjoy each free day and don't look too far ahead.  Good luck to your Mom.  She is lucky to have you and your sister.

[Black]

...  I see some folks who have just had fistulas put in like 4 weeks before and they sometimes don't work because they're not strong enough so I'd say if you know dialysis is down the track.. get it done that way you can build it up and get it strong so when the time comes your fistula can handle it.

Good advice, Richard, and do NOT let anyone try to use an immature fistula.  Using it too soon can ruin it when if they had waited another month or two it would have been fine.  The chest caths are not fun but are much to be prefferred to ruining a fistula by using it too soon.  If they want to use it, and it has been less than two months or it has not fully matured, stick to your guns, put your foot down, whatever you have to do to stop them.  Just flat out refuse to let them use it.  It's your life and your access and they can't use it without your permission.

[Joe Paul]

Mine was placed  for what was supposed to be a year before I started dialysis. Turns out I needed dialysis lots sooner, they used mine only 3 weeks after it was placed.

[KR Cincy]

I had no opportunity to get the fistula before needing dialysis, so I got it one month after they took my second kidney. We waited just over 4 months before we started using it.

[Ang]

my  fistula  was  done  about  8  months  before dialysis,neph  just  looked  at  the  blood  on  a particular  visit  and  reckoned  it  was  about  time  we  did  something  or  we  may  get  caught  out  if  we  leave  it  go.
don't  know  what  the  % were  but guessing  about  10 %  or  lower

[Gram2Twinz]

My husband's nephrologist has always been "proactive".  He always used the lab work numbers as a guide, but he would rather use the answers to "how are you feeling?" as the real determination as to when dialysis would begin. What sysmptoms are you feeling, anything changed since last visit? How's your appetite?- Those types of questions. However,  the problem with chronic kidney failure is that you don't know how bad you feel, until you feel better- which, hopefully, happens after beginning dialysis.
My husband had his fistula placed 3 years before needing dialysis, however at that time- we were looking at 12% function and probably one year or less before needing treatment. Creatnine 7.1
It just happened that his kidney function seemed to stay steady for so long before beginning in-center dialysis.

Our lesson learned: go by how you feel, not always by the "numbers". You are in charge of your own healthcare. Seek advice when you need it, read about your options, and then make your decision. Information is your friend!

[Golferchick]

My father is having his fistula done on Monday. His kidneys are at 20% functioning. According to my mom they have not given a start date for when he would begin dialysis. I am in the process of testing to see if I can donate to him, so  maybe he wont have to start dialysis.  But I didnt realize that the fistula needed to "mature" before being used. I will make sure that my dad (and mom since she pays more attention to it than he does) knows this. This is such a wonderful site full of information - thank you to everyone!

[kellyt]

   Golferchick.  Yes, the fistula should mature for I believe 4-6 months.  Mine was created Oct. 31st and I stiill don't have a large vein.  I have a sonogram scheduled for Monday a.m.

Again, Welcome!

[lola]

Otto has appt Thursday his creatine last week was 4.2 it has been going up the last 3 months so I'm thinking Dialysis in the next year and we know he's doing in center so I'm thinking we need to talk about a fistula? He never had one the last time he was only on for 2 months so he had a line in his neck. He has one Dr who is so sure he'll get a kidney b-4 and even tested for Otto How cool is that but then he has another Dr who says he'll be lucky to find a match

[Joe Paul]

  Golferchick.  Yes, the fistula should mature for I believe 4-6 months.  Mine was created Oct. 31st and I stiill don't have a large vein.  I have a sonogram scheduled for Monday a.m.

Again, Welcome!

My fistula was used at 3 weeks and a day old. That was 1 year 8 months ago and it is huge and still going strong. I was at 10% function when I started.

[Romona]

My nephrologist uses numbers as a basic guide. My function had actually improved. My Creatinine went from 5.5 to 3.5. There were other indications he used to determine that I needed to get the ball rolling. I was becoming increasingly confused. He felt that toxins were building up. Fortunately about 2 weeks after that visit I got the call for transplant.

[ODAT]

Yeah, I'm thinking that if mom's GFR dropped 2% within three months and continues to do that - she would need dialysis in 4 months as it would be at 11%. She is definitely tired all the time and confused 80% of the time - actually forgets she already told you something but she's been doing that for at least 3 years. Her neph wants the vascular doctor to make sure he tries for a fistula first. Thanks for all your info. Helps put prospective on everything. take care.

[caregiver66]

My dad finally had his done the first of Dec. , then I had to take him back last week to have a couple of veins clipped, we see his neph in the middle of Feb., and I am thinking she will keep him and start dialysis. He has only 1 functioning? kidney at a generous 6-7% plus he keeps a creatinin level between 7.76-8. He still wants to wait and see. He's 80 and he wants to wait and I have absolutely no say, it's crazy.