Do fistulas go bad

[paul.karen]

I ask this question because there seems to be a 50/50 split on the answer.

I am thinking of getting a fistula as a backup incase my PD access were to get infected.
I have heard this is a good idea.
I have heard this isnt a good idea.  Only to get it if needed.
I was taught to try and have a backup plan.  To me this is a backup plan.

Curious on your thoughts.

[okarol]

Since Jenna never did PD I don't know from that perspective, but I do know that having a functioning fistula is a comfort. If you need hemo right away the only other option is having a chest catheter inserted.
Fistulas can get blocked but we never had that problem in 3 years. Jenna's quit the day of her transplant, which was scary, in the event the transplant did not work, she would of had have a tunneled catheter put in (which is fine, but we hadn't anticipated it.) I think her case is unique. Fistulas can last for a long time - I know transplant patients who have had theirs for years and they still have the thrill.

[del]

Some people have fistulas done for years before they have to use them. Hubby waited to long to get one when he was on pd and ended up having to have a chest cath put in to change to hemo when he got sick. He had the fistula done but it wasn't matured enough when he had to make the change. Hubby has never had any problems with his fistula. Ben using it now since July 2000!!

[petey]

Marvin's fistula clotted off (no thrill, no buzz, no bruit) about three months after he got his transplant.  Three years later when he had to go back on dialysis, this access couldn't be repaired and/or used again.  He has a different fistula now.

Marvin's brother was on PD for four months before he got a transplant.  His surgeon put in a fistula as a "back up," but Ron never used it.  He's had his transplant for over 14 years now, and his fistula still has a thrill and a bruit.

Go figure.

[nursewratchet]

Fistula's are ALWAYS a good plan.  Hope you never need it, but be thankful for it if you do.  They rarely clot or have any problems.  They can, but rarely do.  They reduce the risk of infection, provide better dialysis, and don't interfere with your life the way a catheter does.  PD may fail, or you may have to for some reason hold off for a while, for whatever reason.  If given the chance, always get the fistula.  Obviously, I am a huge advocate for fistulas,  the ESRD network agrees, if you have to be on hemodialysis, the fistula will GREATLY increase your lifespan.  There is my speel, for whomever has not heard it before.