Time for Fistula?

[Rognoni]

I'm a male 79 years old. My Creatinine level is at 4.0 and my GFR is at 13. I finally decided to do In-Center HD. From other members experience, am I still on time to have a Fistula put in? Will it mature on time when dialysis is needed to start? Trying to avoid access in the neck. Also, according to a recent AAKP article, EV (Endovascular) Fistula, is available, it's suppose to be less invasive procedure with better outcome, perhaps shorter time to mature. Has anyone used it? I value this group's members feedback. Thank you.

[Hidden]

Since I'm not on dialysis I can't speak to your question directly, but I have to ask. Have you spoken yet with your nephrologist and if known, the doctor who will do the surgery? Each of us is different and will respond accordingly to the procedure and those two medical professionals will be better able to answer your questions. Best of luck.

[Darlenia]

Hi Rognoni. In my personal opinion, you'll do fine getting your fistula now - it should have time to mature before you go on dialysis if your labs and blood pressure aren't radically changing. If you wait too long, however, then you do risk hospitalization and multiple procedures - much harder on a person. My husband fits into the later group. My husband waited too long and was hospitalized for an emergency catheter (placed in his chest) and immediate hemodialysis (HD). The precipitating factor was exceptionally high blood pressure (240s/120s) that threatened his life no matter how many pills and blood thinning treatments he received. Dialysis took care of the problem. After being on HD, my husband then switched to peritoneal dialysis (PD) so we can't speak to fistulas. But what was instrumental to our choice of surgeon was a discussion with our dialysis center staff. A PD nurse gave my hubby a list of surgeons and their availability. As she did so, she tapped on one and quietly said, "This is the surgeon for you. He does the best work. Wait for him if you need to. I've never had a patient return here with problems that he created." She then went on to relate some issues that she had seen - an improper cath placement that was hard to access, another placement that interfered with movement, etc. So, my advice to you is to check in at the dialysis center you will be using, and talk to the nurse, specifically in charge of HD, there. If you haven't done so yet, you can always ask your nephrologist for an orientation at that center while mentioning that you would also like to speak to a nurse there that's very knowledgeable about fistulas and your choice of dialysis. As a couple also in our 70s, we wish you well on your journey to better health!

[Rognoni in reply to Darlenia]

Thank you Darlenia for sharing your experience with me. You're a very caring person.