1 Hemodialysis is needed permanently in some patients, this is called maintenance hemodialysis

2 this is performed generally twice or three times per week

3 for dialysis atleast two needle punctures are needed every time, one to draw the blood into the machine and the other to return the purified blood black to the patient

4 therefore the need for a vein access which can withstand so many puncture and also provide a channel for flow of large volumes of blood

5 therefore the surgeon creates a arterio-venous fistula.

6 this means joining a vein to an artery, therefore the high pressure and volume of flow from the artery dilates and strengthens the vein, this creating a channel for permanent dialysis.

7 generally the left hand is preferred since it is the non-dominant hand of most people

8 this surgery needs about two hours to perform and is a day care procedure

9 the patient is advised forearm exercises to generate better blood flow to develop the fistula better.

10 this AVF is the best dialysis permanent access