High Fistula Flow

[Restorer]

Has anyone had problems with their fistula being too good? I had a Transonic flow check on Thursday, and it was over 3500 ml/min (normal "good" fistula flow is between 1000 and 2000 ml/min).

Too much blood flow, especially with an upper arm fistula like mine, can lead to high output heart failure - as opposed to low output like congestive heart failure - where the heart is pumping fine, but the body needs more bloodflow than a healthy heart can provide. In the case of a large fistula, there's too much of a short circuit, and too much blood is going straight back to the heart without circulating.

I haven't taken any BP meds for the last few days, and my blood pressure is staying low-to-normal (strange for me). Low blood pressure is one sign of this kind of heart failure. Another sign is a distended jugular vein on the side of the fistula, which I seem to also have. I'm worried about it.

I need to talk to my doctor as soon as I can see him about this. I'm not really having symptoms that are bothering me yet, but I don't want to start.

Has anyone else had problems with really high fistula flow rates and heart problems?

[Rerun]

Yes, you need to see you vascular surgeon with those numbers.  Maybe have another flow study to confirm those numbers.  They will have to go in and pair/cut it down.  I need to have it done too.  They don't want all that strain on the heart.

The problem is where will they access you while your fistula is healing?  They put a loop graft in my other arm and now that they are using that they want to go over and repair the one with the big flow.

   

[cassandra]

Oh my dear Rerun, and Restorer I'm sorry you have these problems. I'm starting to get depressed at the minute (not only because I'm drinking too much Lemon brandy...) My flow has dropped, and am scheduled for yet again a plasti, and I'm really fed up with it. I really hope it gets all sorted out with that lifeline of ours, sooner rather than later.

lots of luck, and love Cas

[Whamo]

I don't know about the fasts flow and fistula, but I do have experience in dealing with conjestive heart failure.  My ejection fraction went from 19 (disabled) to 75 after about three months of using a supplement by Standard Process called "Cardio Plus". 

[mcclane]

when I was on hemo, our home hemo nurses would do a blood flow check every 3 months.  My latest one wouldn't even register on the machine, the nurse had other nurses check her needle position and no issues were found there, so they all surmised that it was high blood flow (if my memory serves me correctly, I think the maximum the machine would detect was 4000).

none of them mentioned anything about heart problems, but they did say a high blood flow results in poor dialysis.

[Rain]

My dialysis centre follows the following when it comes to fistula blood flows. 

1. A transonic is taken once a month
2 . If the flow rate is 10% high or lower then the previous month they schedule another transonic for the following treatment
3.  If it is still 10% high or lower then the previous months after the second transonic, they contact the vascular nurse to book an appointment for a fistula gram and vascular doctor if necessary
4. If they notice a trending pattern of less then 10% high or lower after a few months, they contact the vascular nurse for fistulagram.
 
They are very proactive at my dialysis center.

[Restorer]

I talked to one of the nephrologists at my center. She said it was a high number, but it might not be correct because of the three Transonics I've had, they've been all over the place. The first one was in the 2000's, the second one was around 1600, and the third one was around 3500. She wants to wait to see a pattern, or at least a couple of consistent numbers, before doing anything about it.

Transonics are done every month at my center.

[Lindia]

I  just saw a post about high flow on one of the facebook dialysis websites.  There is a very neat sounding procedure -  called something along the line of the Miller Banding procedure.    It is outpatient, minimally invasive and more than 90 percent effective.  There is even a you tube on the procedure, where you watch it done.   My hubby has borderline high flow -  so I'm going to push for this kind of procedure, if we ever have to go down that road.