Vascular Access Module #3: AVF Maturation ... - BC Renal Agency

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AVF Maturation1. What are the goals of maturation/needlingassessment?Rule of “6s”: A mature fistula should be:– >6 weeks old (minimum)– >6 mm in diameter with discernible margins when tourniquet applied– 6 cm long– >600 mL/min for access blood flowAny AVF that does not meet the above criteria should beevaluated for non-maturation 4-6 weeks after creation.References:Core Curriculum for Nephrology Nursing“Vascular Anatomy for HD” by Lawrence M. Spergel, MD - BC VAEG Vascular Access Workshop; May200871
AVF Maturation2. How do we know if it is OK to start needling?• Arterialization of vein wall due to increased blood flow» Ideal access flow 800-1200 ml/min» Vessel should be soft & compressible» As the vessel becomes more arterialized, the rebound after compressionshould be stronger.• Thrill should feel like a vibration or purring• Bruit should be a continuous whooshing sound• Vessel depth & size should be appropriate:i.e. >6 mm diameter &
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Vascular Access Module #3: AVF Maturation ... - BC Renal Agency

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