Step 6: Using my Access

Step 6: Using My Fistula or My Graft

When can I start using my fistula for my treatments?

If you have a fistula, it will take a few weeks for it to grow before you can start using it. How will you know when your fistula is ready to use? The dialysis care team will check your fistula each time you have dialysis. They will also teach you how to check it and what you should check for. You will need to check your fistula every day. If the care team has questions about how it is growing, they may send you back to see the surgeon who put it in, a kidney doctor who is an access expert, or an x-ray doctor who knows about accesses.

If there is a problem, you may need to have it fixed.

The care team will be able to tell when your fistula is ready. They will talk with your surgeon about starting to use your fistula. When your fistula is ready for use, your care team will have a plan for how to put the needles in your fistula. The plan will include these steps:

• Putting one needle into your fistula and using your catheter, too.
• Using small needles for your fistula.
• Using your fistula with needles that are a bit bigger.

Many patients have questions about the needles when they start using their access. Ask your care team.

These steps will take a few weeks. When your care team is sure your fistula is working well, you and your care team can start making plans to get your catheter taken out. Make sure you are doing your one minute access check.

When can I start using my graft for my treatments?

It will take a few weeks for your graft to heal before it can be used for dialysis. How will you know when it is time to start using it? The care team will check your graft each time you have dialysis. They will also teach you how to check your graft and what you should check for. You will need to check your graft each day.

The care team will be able to tell when your graft is ready and will talk with your surgeon about starting to use your graft. Most of the time, this will be three to four weeks after it was put in. If the care team has questions about whether it is ready or not, they may send you back to see the surgeon who put it in, a kidney doctor who is an access expert, or an x-ray doctor who knows about accesses. If there is a problem, you may need to have it fixed.

The care team will have a plan for how they put the needles into your graft. The plan will tell them to:

• Put a needle into both parts of your graft.
• Use needles that are the best size for your graft.

When they are sure your graft is working well, you and your care team can start making plans to have your catheter taken out. Make sure you do your one minute access check while you are waiting to use the graft. Go to Step 8 to learn how to do the one minute access check.

Many patients have questions about the needles when they start using their access. Ask your care team if you have any questions. There is a list of questions in the printable manual which you may want to ask.