Hello themrsg,
A fistula generally takes at least 3 months to mature/develop before use in dialysis. Your husband can begin hemodialysis on an in-center or home training basis with a chest catheter if the fistula cannot be used. There should be no medical need to be hospitalized to receive dialysis. A chest catheter is surgically placed and this could be done while hospitalized. The chief concern for your husband is acceptable vascular access to perform dialysis. The high blood flow rates needed for productive and time efficient hemodialysis require arterial access achieved through a central venous catheter, arteriovenous graft, or the gold standard of vascular access, the arteriovenous fistula.
You can read further about the pros and cons of these means of arterial access on this site via this web address link: http://www.davita.com/kidney-disease...ascular-access
I had a fistula placed in October 2011 and started home hemodialysis training in July 2012 - plenty of time for the fistula to mature. We experienced a very high number of infiltrations during the first 1 to 2 weeks of treatments and this led to the need for a fistullogram, which identifed a narrowing (stenosis) at the anastomosis (union of the artery and vein to create the fistula). The stenosis was removed via balloon (venoplasty(?)) and a new array of vessels appeared. Which of these were fistula and which were run off vessels was anyone's guess.
My home hemodialysis training team selected one of the new vessels for the venous (blood return) site and the original portion of the fistula for the arterial site and we began to treat sucessfully without infiltrations. The new vessel was adequate for "push" or return of the blood but inadequate for pull. Its use as the venous site made this constraint moot, and in time the vessel did develop/mature to withstand acceptable dialysis flow rates in push or pull. I've selected another runoff vein for either venous or arterial site and its use has led to development that produces adequate push and pull when tested via a Transonic vascular blood flow/pressure test.
A fistula generally takes at least 3 months to mature/develop before use in dialysis. Your husband can begin hemodialysis on an in-center or home training basis with a chest catheter if the fistula cannot be used. There should be no medical need to be hospitalized to receive dialysis. A chest catheter is surgically placed and this could be done while hospitalized. The chief concern for your husband is acceptable vascular access to perform dialysis. The high blood flow rates needed for productive and time efficient hemodialysis require arterial access achieved through a central venous catheter, arteriovenous graft, or the gold standard of vascular access, the arteriovenous fistula.
You can read further about the pros and cons of these means of arterial access on this site via this web address link: http://www.davita.com/kidney-disease...ascular-access
I had a fistula placed in October 2011 and started home hemodialysis training in July 2012 - plenty of time for the fistula to mature. We experienced a very high number of infiltrations during the first 1 to 2 weeks of treatments and this led to the need for a fistullogram, which identifed a narrowing (stenosis) at the anastomosis (union of the artery and vein to create the fistula). The stenosis was removed via balloon (venoplasty(?)) and a new array of vessels appeared. Which of these were fistula and which were run off vessels was anyone's guess.
My home hemodialysis training team selected one of the new vessels for the venous (blood return) site and the original portion of the fistula for the arterial site and we began to treat sucessfully without infiltrations. The new vessel was adequate for "push" or return of the blood but inadequate for pull. Its use as the venous site made this constraint moot, and in time the vessel did develop/mature to withstand acceptable dialysis flow rates in push or pull. I've selected another runoff vein for either venous or arterial site and its use has led to development that produces adequate push and pull when tested via a Transonic vascular blood flow/pressure test.
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