Fistula and Graft Complications
Pain, swelling, skin changes, bleeding or poor dialysis flow can signal an access problem. We assess narrowing, clotting, aneurysms, infection and reduced blood supply to the hand.
Your Clinical Care Pathway
Assessment combines symptoms, skin and circulation examination, dialysis records and imaging when indicated.
Management may involve changes in needling, observation or referral for an endovascular or surgical procedure.
Expected benefits and limitations
The goal is safe dialysis and protection of the hand and skin. Aneurysm size alone does not determine repair; growth, bleeding, skin condition and function matter. Preserving an access is not always possible.
Clinical Preparation Checklist
Ensure safety by confirming these items before arriving at our medical center.
Frequently Asked Questions
Dialysis Access Salvage and Revision
A failing or clotted access may sometimes be restored. Early assessment helps determine whether repair is appropriate and how dialysis can continue safely.
What to expect
The team evaluates the cause and may arrange access imaging, balloon treatment, clot removal or surgical revision. If salvage is unsuitable, a temporary solution or new access may be needed.
How to prepare
- Contact the access team promptly after loss of function and bring recent dialysis and access records.
- Follow procedure-specific medicine and fasting instructions.
Expected benefits and limitations
Treatment may restore use and reduce catheter dependence, but success and durability vary. Repeated narrowing or clotting can occur. There is no guaranteed 12-month patency for an individual access.
Seek immediate urgent care or report to our dialysis unit if you experience:
Loss of vibration needs urgent review; heavy bleeding or severe hand pain needs emergency care.
Will a successful procedure mean the problem is permanently fixed?
Not necessarily. Follow-up is needed because the access may develop recurrent problems.
Clinical References & Literature
- [1]KDOQI Vascular Access Guideline and Implementation Tools (2019 guideline; published 2020 · US guideline)
- [2]NIDDK Hemodialysis (Current patient resource · US government patient information)
Emergency Red Flags
Seek immediate urgent care or report to our dialysis unit if you experience:
- Bleeding from an access
- An ulcer or scab over a rapidly changing swelling
- Severe hand pain
- Heavy bleeding — apply firm direct pressure with clean gauze and seek emergency help immediately
Assigned Specialty Team
Led by Senior Consultant Nephrologists.
Request Consultation
Schedule a digital triage review or in-person clinical assessment with our specialists.