“Is fistula necessary for a CKD patient?”
The doctors have been advising us to get a fistula done for my mother who is a CKD patient. Do you think it is really necessary?
4 Answers
Unless her steady state GFR is <20ml/min/BSA probably not.
If she is CKD stage 5 and her nephrologist thinks she is close to dialysis then yes, a fistula is better to have done before starting dialysis so that it is ready to use in the next few months.
The reason that we prefer to have a vein or artificial vein for hemodialysis is that the chances of infection are very much better. The catheter being used for dialysis now has a tip that is right at the edge of going into the heart. If it gets infected, the heart is possibly infected, which may mean that she would have an infected heart valve. The infected end of the catheter may send bacteria off to distant places, like the disks in the back, causing the bones (vertebrae) to be infected and collapse. The bacteria may go to the brain or to muscles. Or the bacteria may cause a condition called septic shock, where the person is very ill, in the ICU, blood pressure is low, and death may be near. Yes, if she is committed to stay alive with dialysis, it should be done.
Yes for dialysis
