Dialysis Management Santa Fe: How to Monitor Your Dialysis Fistula

Dialysis Management Santa Fe provides hemodialysis services to patients with either arteriovenous or peritoneal dialysis. Our fistula experts can provide comprehensive fistula management and are available at all hours of the day and night to ensure that your dialysis treatments are running smoothly and safely. If you have any questions about managing your fistula or would like more information, contact us today!

What is this all about?
A fistula, or a vascular access graft (VAG), is a surgically created connection between an artery and vein. These grafts are typically implanted in patients requiring hemodialysis because conventional vascular access routes don’t function properly with such rigorous treatment. The purpose of these grafted connections is to remove wastes that have accumulated in blood during treatments. Patients with dialysis fistulas have unique needs. The flow through the fistula must be maintained above a certain level to allow adequate hemodialysis. The fistulas can be monitored with Doppler and color-flow ultrasound to determine if a narrowing (stenosis) is developing or if there is any arteriovenous backflow occurring in your blood vessels within 48 hours of your treatment session.

What are the common methods of monitoring a fistula?
The most common methods of monitoring a Dialysis Management Santa Fe include ultrasound, Doppler sonography, and pressure-based measurements. The purpose of these tests is simple: we want to make sure that blood flow through your fistula remains above a certain level. A decreased blood flow through your fistulas means that you’re at risk for clots forming (thrombosis) or narrowing (stenosis). If left unchecked, these issues can be life-threatening.

Why should I use Doppler instead of color-flow?
While it’s possible to use color-flow ultrasound for monitoring, Doppler offers several advantages over color-flow. First, Doppler allows you to see how blood is flowing in two dimensions—it displays depth as well as side-to-side movements. This means that you can monitor deeper fistulas more effectively with Doppler than with color flow. Second, using one probe can give a more complete picture of your fistula than using multiple probes. Using multiple probes gives you more accurate information about flow rate and patency (width), but it also means that there are some gaps where blood could be flowing that you aren’t able to see.

When do I check my fistula on weekdays?
When you check your fistula depends on your hemodialysis schedule and how often you are dialyzed. The two most important times to check are right before you start hemodialysis, and just as soon as you finish. Your fistula must remain open during treatment because blood flow is what carries waste products out of your body. If it becomes blocked, treatment may not be effective or could cause injury or infection.

If your levels drop, what should you do?
If your hemodialysis levels drop, contact your nephrologist for immediate treatment. Some doctors will have you come in for an extra session or two immediately and others will require that you maintain a certain level for 24 hours before coming in. Either way, it’s important to call and arrange care as soon as you realize there’s a problem so that no permanent damage is done while waiting.

What other issues should I know about?
A lot of people with dialysis fistulas have other issues that could impact monitoring. For example, some patients have diabetes or neuropathy which can lead to changes in circulation. This means you may need more frequent hemodialysis to ensure you’re keeping up with your fluid management needs. Make sure to discuss other medical conditions with your doctor before coming up with a plan for monitoring and make sure you get plenty of rest so your body is at its best!