What is maturation of AV fistula?

A major obstacle to successful AVF creation is maturation, as about 30–50% of AVFs fail to mature. Maturation mostly occurs 4 to 6 weeks after the initial fistula surgery but that timeframe can vary with the average time ranging from 1 to 4 months. Thus, maturation of AVFs can be a relatively unpredictable process (4).

How long does a typical AVF require for maturation?

Current guidelines recommend at least 6 weeks for AVF maturation, which is usually associated with prolonged use of central venous catheter (CVC) in patients requiring urgent HD.

How do you mature a fistula?

A fistula is mature when it can be routinely cannulated with two needles and deliver a minimum blood flow (typically 350–450 ml/min) for the total duration of dialysis, usually 3–5 h for high efficiency hemodialysis.

Why do AV fistulas mature?

The autologous arteriovenous fistula needs time to mature and for the vein to enlarge to a size where it can be needled for dialysis. A fistula that fails early is one that either never develops adequately to support dialysis or fails within the first three months of its use.

What helps AV fistula mature?

Surgical methods used to improve AV fistula maturation: Vessel thickening angioplasty -deliberate fracturing of vessel wall causing inflammation of vein, resulting in wall thickening. Competing branch vein elimination – embolization or surgical ligation of competing branch veins over 3-8 mms in diameter.

How long can AV fistula last?

End points for survival analysis were spontaneous or surgical AV fistula closure, or construction of a new vascular anastomosis. The survival for the first AV fistula was 90% at 1 year, 80% at 2 years, and 66% at 5 years, and for the second AV fistula, 84% at 1 year and 72% at 2 years.

What is the rule of 6’s?

This rule recognizes that all communication takes place within the context of a relationship. If you want to build a supportive relationship, you need to give the other person in the relationship at least six positive comments for every negative one.

When is a fistula ready?

When will my fistula be ready? Over time, the vein becomes bigger and its walls become thicker and stronger due to the increased blood flowing through it. We call this “maturing”. Usually it takes around 6-8 weeks after it has been created before it is ready to be used.

What is the most common complication of AV fistulas?

Heart failure. This is the most serious complication of large arteriovenous fistulas. Blood flows more quickly through an arteriovenous fistula than it does through typical blood vessels. The increased blood flow makes the heart pump harder. Over time, the strain on the heart can lead to heart failure.

How many times a day do hemodialysis patients do arm exercise to achieve fistula maturity?

Upper arm Fistula: Exercise 1 Start with your arm down at your side and slowly curl your arm. Do this exercise 4 times a day for 5 minutes.

Which exercise is best for fistula?

To perform fistula exercises:

  • Get a tennis ball, nerf-ball, or other soft ball you can hold comfortably in your hand.
  • Place the ball in the hand on the same side as your fistula.
  • Squeeze the ball 10 to 15 times a minute for 1-2 minutes.
  • Repeat this exercise 10 to 20 times each day.