Video: Dialysis Fistula Problems: Don’t Wait Until It Blocks!

If you are on blood dialysis, your fistula or graft is your lifeline. So if it becomes difficult to needle, the flow seems poor, pressures are high, bleeding takes longer to stop, the arm becomes swollen, or the fistula starts looking very enlarged or painful, please don't just wait and see. These can be signs of narrowing, blockage, aneurysmal change, infection or poor flow through the access.

The important point is that many of these problems can be assessed before the fistula completely fails. A vascular assessment can include an ultrasound scan or a fistulogram. You may need balloon angioplasty, stenting or surgical revision, depending on the problem. If the access clots suddenly, dialysis may be interrupted and a temporary catheter may be needed, and that carries its own risk.

So access problems are not minor technical issues. If your fistula or graft is changing, difficult to use or repeatedly troublesome during dialysis, it deserves early vascular review.