Fistula insertion

I have been on PD for almost 2 years and am very satisfied with this method. My nephrologist now wants me to have a fistula in place just incase I need to do Hemo at some future time. Is this the norm for most PD patients?

There’s a big push in government and in kidney community to promote the use of fistulas in all patients for hemodialysis and in case hemodialysis is ever needed. A fistula is considered the best type of vascular (blood) access because of its lower risk of infection and clotting.

http://www.cms.hhs.gov/ESRDQualityImproveInit/04_FistulaFirstBreakthrough.asp

I’d ask your your doctor or nurse…
– Why do I need a fistula how if I’m on PD?
– Is there a problem with my PD? If not, can’t I get a fistula later if there is a problem rather than now?
– What is fistula surgery like?
– Where would I have it and who will do it?
– How long would I need to be in the hospital?
– What will I feel like after surgery?
– What limitations will I have after surgery?
– How much will it cost and what will my insurance pay?
– Anything else you think of…

If your PD is going fine and you dont want a fistula well thats up to you. I was on PD for 18 months and no one said anything to me about getting a fistula. Personally, I wouldnt. I would only do it if PD was starting to fail.
Fistulas arent always successful. What if they created a fistula, whilst you were having success with PD, and the fistula stops working. There, you have a ruined potential future access site for no reason.
Im no expert though, I would be asking your doc more about it.