AV Fistula Ruptures And Hemorrhages - Signs And Symptoms Often Missed Can Be Deadly For CKD

As you are well aware, AV Fistulas are Dialysis patients' lifelines. If you are reading this right now, you may have a Fistula or know someone with this delicate lifeline. It is unfortunate that ironically the very Fistula which is necessary to sustain a person's life, can suddenly become the reason they bleed out; and may in fact lead to their death within just minutes.

Recommended Reading: How Chronic Kidney Disease Patients Can Reduce The Risk Of Bleeding-Out, Fistula Failure And Worse

Though unpleasant to hear, people on Dialysis suffer with ruptured or damaged AV Fistulas, but often do not know the signs and symptoms that indicate a potential problem or even actions to take in order to prevent a serious, life threatening Hemorrhage (profuse bleeding from ruptured blood vessels).

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Author, Greg Collette, mentions a few examples, "Coby  wrote about a dialysis patient who nearly died when her infected fistula burst.  Salma’s father was saved by intensive care when is fistula bled out.  Steve’s father bled to death in 10 minutes when his fistula burst after two weeks of problems.  Mek’s father bled to death after multiple bleeds over a few weeks.  Sandy’s husband had an emergency flight that saved his life after his fistula Hemorrhage.  Ebony’s father found his wife on the kitchen floor after her graft burst." 

Recommended Reading: Dialysis Patients' AV Fistulas May Be Competing With Their Hearts, Causing Heart Failure

Yes, the idea that your Fistula keeps you alive, but also can threaten your life is an unsettling fact you have to live with. You should be aware that your Fistula is a massive pressurized blood vessel and a small tear or break can cause you to bleed uncontrollably and in some cases cause your death. 

Recommended Reading: What is the Proper Way for Chronic Kidney Disease patients to control a Bleeding Shunt?

Hence, what exactly can YOU do to prevent this from happening? Well, you should know that often your Fistula ruptures at night. Although this is not ALWAYS the case, it is frequently the pattern so you may not have "fair warning." If your Fistula arm is at any time red and sore or has weak spots that fail to re-seal after needling it may be infected or blocked; and you should seek medical attention immediately! Do not rely entirely on your Dialysis Technicians to catch an issue, YOU should remain vigilant and bring any concerns to the attention of your Healthcare Team. It is, after all, YOUR life at stake.

Recommended Reading: Is Use of Heparin in Dialysis as Safe as Dialysis without Heparin?


Regularly look for any pain, swelling or discharge which could be a big red-flag of an infection. Infections which start on the outside of your Fistula near an access hole can, if untreated, gradually burrow into your Fistula and eat away at its wall, creating a hidden, fatal point of weakness. Tell your Nurses or Nephrologists as soon as you notice signs of an infection. They will likely provide you with the appropriate Antibiotics (cure disease by killing or injuring bacteria).  

Recommended Reading: Chronic Kidney Disease Patients Can Now Predict And Prevent Deadly Infections Before Serious

Any Fistula problem can become life threatening so be scrupulous with your hygiene.  Wash your hands and your Fistula when you arrive at your Dialysis Clinic, and again before you leave. Dress and sterilize any cuts or scrapes on or near your fistula, and look for blockages by lifting your arm over your head and checking that it recovers its shape when you lower your arm. 

Recommended Reading: Obstruction in AV Fistula can cause Dialysis Patients to Lose Fingers or even a Hand

Do you now feel a bit more equipped to tell the signs and symptoms that indicate a potential problem? Discuss this matter with your Healthcare Team to garner any other to ensure the safety of your Fistula. For more information about how Chronic Kidney Disease and Diabetic patients can better manage their lives, visit KidneyBuzz.com daily. 

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Reference:

"Dialysis, Fistulas and Fatal Haemorrhages." Http://www.globaldialysis.com. Global Dialysis.

"Fatal Vascular Access Hemorrhage: A Horrific Preventable Event." Http://www.medscape.com/. Medscape Medical News.

"Treatment of Subdural and Intracerebral Haematomas in a Haemodialysis Patient with Tranexamic Acid." Http://ndt.oxfordjournals.org/. Oxford University Press.