Dialysis Access

Creation and maintenance of arteriovenous fistulaes and grafts are an important part of our practice. This community has a large population that require dialysis. Royal North Shore Dialysis Unit and Lindfield Dialysis Centre are closely affiliated with our practice.

We work in close association with our renal physicians. When dialysis has been decided on, we can create the ideal access for you. Planning requires ultrasound assessment of the arteries and veins in your arms and/or legs to choose the best possible option. Ideally, we prefer the non-dominant arm with access closer to the hand so that it can be easily accessed and is more comfortable for you. Your own vein is the best conduit available to form an arteriovenous fistula. However, if there is no suitable vein, we can use prosthetic material instead and the access is then called arteriovenous graft.

Timing of surgery is planned with the renal physician and yourself. Most arteriovenous fistulaes take 6 weeks to mature before they can be accessed. Arteriovenous grafts take 2 weeks to mature before they can be accessed. We will see you with and ultrasound scan before this time to ensure the access is maturing well. The renal unit has excellent staff to educate and support patients starting dialysis with their new access.

Maintenance of your arteriovenous fistula and graft is important to avoid loss of the access. With ongoing use, these fistulaes and grafts change with time. There is a better outcome if we can revise the access prior to it going down/thrombosing.