Fistula Questions

[AnnieB]

Hi, I'm just wondering if there's any ballpark timeframe that a "normal" (if there is such a thing) fistula will last. The reason that I'm wondering is that my fistula is in my upper non-dominant arm, and I'm wondering if that means that if for any reason it fails, I wouldn't be able to use any other place on that arm for access. Would I have to go to my dominant arm or else have a catheter or do PD? I didn't think to ask this before. Is it standard for the surgeon to place the access in the forearm first and then go to the upper arm if the forearm doesn't work out? Not that I'm paranoid, just that I keep hearing stories about fistula problems.

On a good note, it turns out that the doctor who did the surgery is one of the top doctors in this area who specializes in vascular surgery (I didn't realize that when I was referred to him, just found it out today). So maybe he couldn't place a fistula lower down and that's why he did it on my upper arm. I'm due to see him again in a couple of weeks and he should let me know how it looks. The bruit and thrill still seem to me to be working. I see my neph next Tuesday - so he can let me know if I'm checking it correctly.
 

Wish I wasn't so ignorant about all this.

[amanda100wilson]

They go for forearm first, but particularly in women, these veins are often of too small a diameter.  I was told after I had my fistula that some docs. in such circumstances will do a forarm graft first since this helps th veins higher up develop somewhat  to make an upper arm fistula as necessarywhen the graft is no longer useable.

[Angiepkd]

My surgeon tried to make the forearm fistula, but it did not mature.  Next step was upper arm.  It matured too well and I had to have the flow reduced.  It has worked fine since the revision.  From what I am told, if my upper arm fistula fizzles out, the next place would be my dominant arm.  From there they go to femoral arteries in the legs, and last option is a chest catheter.  I hope and pray it doesn't come to all that.  I try to take very good care of my working access.  I understand how important it is.  Try not to worry about what ifs and follow your surgeon's instructions in caring for your fistula.  It truly is your lifeline!  You will do great!  Ask questions at your next appointment and I am sure they will put your mind at ease.  Best of luck to you!   

[RichardMEL]

My fistula (wrist) is going strong just over 9 years in. The latest KidneyTalk episode has a patient who claims to be using the same Fistula for 36 years..... so they can last a heck of a long time!