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Topics:
Nephrology • End stage kidney disease
How do you approach recommending an AVF for a patient with advanced CKD who is concerned about the cosmetic appearance of the fistula?
Answer from: at Community Practice
Assuming that the patient is either not interested or not suitable for peritoneal dialysis and they do not have a potential living donor, I discuss the risks/benefits of AVF vs a tunneled catheter. I offer upper arm AVFs to these patients (even if forearm vessels are adequate), as sometimes they are...
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Answer from: at Academic Institution
I have encountered this scenario in the past. I was finally able to convince the patient to receive an AV graft, as it is cosmetically less risky to develop aneurysms. However, it took a couple of years. Persistence may be the best option.