How long before I can use it?

Usually about six weeks, the time it takes for the vein to grow thicker and stronger so it can handle dialysis needles. A graft can sometimes be used a bit sooner.

What's the difference between a fistula and a graft?

A fistula connects your own artery and vein directly. A graft uses a soft synthetic tube to make the connection when your own veins aren't suitable. Both create reliable dialysis access, but a fistula is generally preferred when it's an option.

Why is a fistula better than a catheter?

A fistula sits under the skin and lasts far longer, with a much lower risk of infection than a temporary dialysis catheter. Creating one early often avoids the need for a catheter altogether.

How do I take care of my fistula?

Feel for the gentle buzzing (the “thrill”) each day to confirm blood is flowing, keep the area clean, and avoid pressure, tight sleeves, or blood-pressure cuffs on that arm. Call us if anything changes.

What are the risks of fistula surgery?

Fistula surgery is routine, but complications can happen: a fistula that's slow to mature, narrowing or clotting, infection, or (uncommonly) steal syndrome, where the hand gets too little blood and feels cold or numb. We map your veins first to choose the strongest site, and we monitor the access afterward so problems are caught early.

What if my fistula stops working well?

Veins can narrow over time. We treat that with an outpatient procedure called a fistulogram. A small balloon (angioplasty) or a stent reopens the access, and your dialysis continues with minimal interruption.

Fistula for dialysis, reliable access for every treatment

If you're preparing for hemodialysis, you'll need a safe, durable way to connect to the dialysis machine, one that holds up to treatment several times a week. An arteriovenous (AV) fistula is the gold-standard access: a connection between one of your own arteries and a vein. Empire Vein's surgeons are the region's leading experts at creating and maintaining it.

Experience

1,157

Dialysis fistulas created by our team

Maturation

~6 weeks

For a new fistula to be ready

Setting

Outpatient

Avoids a higher-risk dialysis catheter

What is a dialysis fistula?

Hemodialysis works by drawing your blood out through a needle, filtering it through a machine, and returning it, usually a few times a week. That's a lot of needle punctures, and ordinary veins can't take it for long.

An AV fistula solves that. When we connect an artery to a nearby vein, the added pressure makes the vein grow thicker and stronger over a few weeks, creating a durable access point that stands up to regular dialysis and helps protect your other veins. When your veins aren't suitable, a soft synthetic tube called an AV graft does the same job.

Built to last

A fistula uses your own vein, strengthened over time, for the most durable, long-lasting access.

Lower infection risk

It sits fully under the skin, avoiding the higher infection risk that comes with a dialysis catheter.

Fistula or graft

If your veins aren't ideal, a soft synthetic graft provides the same reliable access.

Dr. Nina Grewal

Board-Certified • Fellowship-Trained Vascular Surgeon

What our doctors think

“A well-planned fistula changes everything for someone on dialysis: it lasts for years and keeps infection risk low. We don't just create the access, we watch over it, so treatment never has to stop.”

How it's created

Getting a fistula ready is a step-by-step process that starts well before your first dialysis session.

Mapping your veins

At your consultation, an ultrasound maps the veins in both arms to find the best one, usually in your non-dominant arm.

Connecting artery to vein

In a short procedure, your surgeon joins an artery to a nearby vein so stronger, high-pressure blood flows directly into it.

Allow about 6 weeks for your new fistula to heal and mature before its first use.

Ready for dialysis

By then the vein has grown thick and strong enough to comfortably handle dialysis needles, and it's used for every treatment, with no temporary catheter needed.

Caring for your access

A fistula or graft needs a little attention to keep working well. Feel for the gentle buzzing (the “thrill”) each day, and watch for these uncommon but important signs.

Let us know if you notice

Swelling, redness, or drainage at the site

Fever, aches, or other signs of infection

A bruise that keeps spreading after dialysis

Call us right away for

No buzzing or vibration (the “thrill”) over the fistula

A hard, pulsating knot under the skin

Coldness, numbness, or weakness in the hand

These are uncommon, but catching them early protects your access. Losing the “thrill” can mean blood flow has stopped. Call us promptly so we can restore it and keep your dialysis on track.

Why choose Empire Vein

The region's leading experts in dialysis access

Our fellowship-trained vascular surgeons don't just create your access. They keep it working. When a vein narrows, we treat it with a minimally invasive, outpatient procedure called a fistulogram so dialysis continues with little interruption.

1,157

dialysis fistulas created to date

523

AV grafts completed

4.8★

from 2,000+ verified patient reviews

6 offices

across Southern California

Dialysis access, answered

The questions patients ask us most about fistulas and grafts.

Ideally weeks to months before you start dialysis, because a fistula needs about six weeks to mature. Your kidney doctor (nephrologist) will recommend the timing based on your lab values and how your kidney function is trending.

Insurance

When your veins cause symptoms like aching, swelling, or skin changes, treatment is typically considered medically necessary, including under Medicare. We'll help you verify your benefits.

Most major plans accepted