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What should I do?

My fistula is not working?

-         If there is no vibration in your fistula, most likely a clot has formed in your fistula. Don't panic.  Exercise with a rubber ball in your hand. If there is no work on the fistula, immediately contact your dialysis center or vascular surgeon and report the situation.

-         It is very important for you to detect this situation. Early interventions (Medication and Fistula Massage) can make your fistula functional. For this reason, check your fistula every day.

-         With a surgical intervention called early revision, the clot formed is removed and, if necessary, your fistula is recreated. In this case, you can continue your dialysis through the fistula without the need for a catheter.

-         The same process can usually be applied to your graft.

-         When early revision fails or a new fistula is made from a higher level, you may need to continue dialysis with a catheter for a while.

Blood leaked under the skin in fistula?

Blood leakage from the fistula under the skin occurs as a result of the damage caused by the needles to the fistula. Pressurized fistula blood comes out of the needle entry area and creates swelling and tension in this area. This situation is called hematoma formation.

The most common causes of hematoma formation:

-         Your fistula is new and your vessel wall is not yet mature.

-         Your blood vessels are very thin and their walls are very fragile.

-         Blood pressure in this region is high enough that the vein cannot tolerate it.

-         It took many attempts to insert the needle into the vein.

-         The needles created a large hole in the vein wall.

-         The needles were not identified well by the dialysis nurse.

-         The needles have become dislodged or widened the hole in your vein as a result of uncontrolled movements of your arm.

-         Always be very careful when moving your arm with fistula during dialysis. Inappropriate and uncontrolled arm movements may cause the needle to come out of the fistula or cause excessive bleeding by rupturing the fistula.


When a hematoma forms in your fistula:

-         Swelling in your arm, pain, tension, and redness around the needle insertions will improve over time.

-         This area will receive ice  in the first 24 hours. apply.

-         After 24 hours, dry and hot compresses can be applied in 2-3 sessions of 30 minutes. Excessive hot applications are undesirable and may cause damage to the skin.

-         It may take 1-2 weeks for this hematoma to dissolve.

-         If your fistula is unusable, you can continue dialysis with a temporary catheter until your arm returns to normal.


Is there increased temperature and sensitivity in the fistula?

-         Increased skin temperature, pain, and redness suggest the possibility of infection. In this case, notify your dialysis doctor immediately.

-         If infection is suspected in the fistula, you will be asked for blood tests. Antibiotic treatment is started.


There is ballooning in the fistula. Can my fistula burst?

-         When dialysis needles are constantly applied from the same place, enlargement of the vessel (aneurysm) may occur in this area. The skin in this area may thin over time.

-         In this case, consult your vascular surgeon immediately. Fistula intervention may be required by your surgeon. May the fistula need to be revised, closed, or a new fistula opened?

-         If this vein bursts (severe bleeding in the form of gushing)) when it develops; Apply strong pressure to the bleeding area and immediately call the emergency ambulance service (112). This is a very urgent health issue for you.


In what cases should I notify my doctor immediately?

-         When there is blood leaking from your fistula under the skin or outside.

-         When you have excessive edema and swelling in your arm.

-         When there is fever, chills and chills.

-         When you have pain, redness and increased skin temperature on your fistula arm.

-         When vibration decreases or disappears.

-         When you think there is a possibility that your fistula may rupture outside.

-         In cases where bleeding is prolonged after dialysis and when bleeding starts again.

-         If you have painful, cold hands and bruised fingers after dialysis.

-         When you feel extreme pain in the dialysis catheter area that does not go away.

-         If you notice bleeding from the dressing covering the catheter.

-         When your catheter becomes dislodged.

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