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An AV fistula connects an artery directly to a vein. An AV graft connects them using a soft tube placed under the skin. Both can provide reliable access for hemodialysis. The right choice reflects your blood vessels, treatment timing, overall health, and preferences — as part of a personalized dialysis plan made with your kidney care team.
AV fistula: made from your own vessels
A surgeon connects an artery to a vein, usually in the arm. Over weeks to months the vein enlarges and strengthens — "matures" — until it can support dialysis needles (AV fistula details).
- Uses your own tissue — once mature and working, infections are less common
- Needs maturation time before it can be used
- Some fistulas fail to mature and need further evaluation or a different plan
AV graft: a planned alternative
When a patient's veins aren't suitable for a fistula — or dialysis needs to start sooner — a graft connects artery and vein with a synthetic tube (AV graft details).
- Often usable sooner than a fistula; timing depends on the graft and your care team's assessment
- A reasonable planned choice for some patients, not merely a fallback
- Carries higher risks of clotting and infection than a mature fistula, which your team monitors for
Side by side
| AV fistula | AV graft | |
|---|---|---|
| How it's made | Your artery joined to your vein | Synthetic tube connecting artery and vein |
| When it may be usable | After maturation (weeks to months; varies) | Sooner, per your care team's assessment |
| Main advantages | Own tissue; fewer infections once working | Available when veins aren't suitable; earlier use |
| Limitations | May fail to mature | Higher clotting and infection risk |
| Questions to ask | "How likely is my fistula to mature?" | "How will we monitor for clotting?" |
Maintenance: what both share
Either access is checked at every dialysis session, and problems — significant narrowing, clotting, changes in the thrill — get specialist evaluation and treatment when there are clinical signs of dysfunction. Routine preventive procedures on a well-functioning access aren't recommended; responsive care when something changes is.
Frequently asked questions
What happens if a fistula doesn't mature?
It gets evaluated — imaging can show why, and options range from a corrective procedure to a different access plan. Your team will discuss what fits your situation.
Is a fistula always the better choice?
No. Fistulas have real advantages once working, but access planning also weighs dialysis timing, the chance of successful maturation, your health, and your preferences. For some patients a graft — or for some, a catheter — is the appropriate plan.
Who takes care of my access long-term?
Your dialysis team monitors it; an access specialist evaluates and treats problems; your nephrologist coordinates the overall plan. It's a shared job.
Discuss your access options with your nephrologist and care team. For access evaluation in Pompano Beach, request an appointment or call (561) 408-0304.
This article is general health information, not medical advice, and does not replace an evaluation by a clinician. If you think you are having an emergency, call 911.
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