Abstract: SA-PO0443
Early Placement of Arteriovenous (AV) Fistula Delays Dialysis Initiation
Session Information
- Dialysis: Vascular Access
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Sterrett, James Reid, Nephrology-Hypertension of Naples, P.L., Naples, Florida, United States
- Alvarado, Alejandra, Nephrology-Hypertension of Naples, P.L., Naples, Florida, United States
- Perez, Melanie, Nephrology-Hypertension of Naples, P.L., Naples, Florida, United States
Introduction
Having an Arterio-Venous Fistula placed early is best for the patient.
The experience described below suggests that dialysis initiation can be delayed significantly with the early placement of an AV fistula.
Case Description
This 80-year-old female with IDDM, HBP, AOCKD HPTH ASHD AS PVD, began dialysis in May 2023. Her AV Fistula was used.
The fistula had been placed in 2005 while living in New Jersey. Her nephrologist then indicated that she would require dialysis in less than one year. She moved to Florida in approximately 2010. Her creatinine was 2.5, eGFR19.
Over the course of the next 13 years her creatinine very gradually increased from her base line of 2.5 and an eGFR 21-19. With meticulous personal care, her DM was stable and her ASHD did not progress. She began dialysis in May 2023 with a creatinine 2.96, eGFR 16 and progressive uremic symptoms.
Discussion
A retrospective review of our patients revealed 23 patients whose dialysis initiation was delayed with an early fistula placement.
The range was 6 months to 216 months. The average number of months’ delay was 41.0 months until the start of dialysis for 15 patients.
The average number of months for those still waiting to initiate dialysis is 31.8 for 8 patients.
We conclude that early fistula placement delays the need for initiating dialysis.
We propose that early fistula placement not only affords the delay in starting dialysis, but could be a viable strategy for postponing dialysis for patients who have been referred for a renal transplant prior to commencing dialysis.
Furthermore, the early establishment of an AV fistula may serve as an effective approach to mitigate the decline of patients who are expected to require dialysis but choose to forgo the treatment entirely.