Median Nerve is compressed in the forearm by AV Fistula

Dear Doctor,


I am on HemoDialysis for the last 12 years with AV FISTULA ( Radial Cephalic) as access.
Recently for last 3 months I have been started feeling “numbness” in the palm and fingers only in the mid night of some days on and off.

But slowly that has become more severe and for the last 20+ days, I had to wake up after every hour of the sleep with this numbness & PAIN, then stand up out of the bed to get away from this numbness. So, with this it is becoming very trouble to get sleep though out the night.
My Nephrologist advised to take Pregabalin-50mg at night. Initially for 2-3 days it worked and not noticed any pain or numbness through out night, but afterwards again same symptoms and sleep disturbance.

I have consulted a Neuro-physician, he asked to get a ENMG study on nerve conduction. The Report says - “Moderate left Carpel Tunnel Syndrome in addition conduction block noted in forearm”.

Then the Doctor asked to get one more SCAN, i.e. Hight Resolution Nerve Ultrasound scan.
That shows: Median Nerve compression in the forearm segment by the blood vessels of AV Fistula.

Need to know from you:
May I know your opinion that what shall be the best treatment for this problem?
1, AV Fistula is perfectly working. Then is there any special procedure to readjust the AV Fistula so as not compress the median Nerve?
2, May you advise any medical solution with out the need of surgery?
3, If it is surgically repaired, does this require - Vascular surgeon and Neuro surgeon both together to work on this?
4, is this fistula to be closed and no more can be used as this is causing Compression on the Median Nerve?

I request you to please study my case and spend some of your valuable time to advise me comprehensively with all your vast experience, further which can help me to work on my plans confidently to overcome from all the above mentioned sufferings.

Thank you very much Sir,

Best regards,


do you have a aneurysm ?

Here’s a 2020 article titled “Surgical intervention for upper extremity nerve compression related to arteriovenous hemodialysis accesses” that may describe the symptoms you’re having. If so, you might want to show it to your nephrologist and vascular surgeon. It looks like surgery can fix the problem.