Renal Dialysis

Hi, my name is Dr Hmanshu Verma. I am a Vascular and endovascular surgeon.

Dialysis aaj kal bohot he common hai. Renal Failure aaj kal bohot he common hogya hai. Aur ek point pe kidneys certain damage ke beyond hojati hai to uske baad patient ko permanent dialysis ki zarurat hoti hai. Dialysis ke liye normally gale me line daal kar usse blood ko dialysis machine tak lejaya jata hai. Aur clean blood ko wapas body me daalte hai. Lekin unfortunately in lines ko bohot zada der tak body me nahi rehne dia ja sakta hai. Kyuki isse infection ka khatra rehta hai aur sath he yeh lines ander ki nerves ko block karne lagti hai. Iske liye AV Fistula surgery ki zarurat hoti hai. Ideally hume ek aisi khoon ki nass ki zarurat hoti hai jisse khoon ko body se nikal kar dialysis machine tak lejaya ja sake aur wahan se clena blood ko wapas body me daale.

Aisi koi khoon ki nass actual me exist nahi karti hai jiske lie 2 khoon ki artery or vein ko surgery karke aapas me jod dete hai. ise AV Fistula surgery kehte hai. Ek baar AV Fistula surgery karne ke baad 5-6 hafte me vein badi hojati hai size em aur usme khoon ka flow badh jata hai, tab yeh fistula taiyar hoti hai.

AV Fistula surgery baaki surgeries se isliye alag hoti hai kyuki yahan pe koi cheez bana ke dete hai apko jisk baar baar needle daal ke istemaal hota hai. Kisi bhi jagah hum bar bar needle daalte hai to wo 6 months ya saal bhar me damage hojati hai. Isliye we talk in terms of ki AV Fistula ki ek life hoti hai. Isliye agar AV Fistula agar fail hojati hai to doosri AV Fistula ki zarurat padti hai. Agar failed AV Fistula aap sahi samay pe pehchan jaae to fir usko bachaya bhi ja sakta hai. Ek chalti hui AV FSIstula me bhi kahi baar complications ho sakte hai.

AV Fistula ki wajah se kuch patients ko haath me swelling aane lag jati hai. Adhiktar humne dekha hai ki in patients ki jo chaati k ander ki jo nerves hoti hai, unme narrowing hoti hai. Un narrow nerves ki wajah se haath me swelling ane lag jati hai. Aise mareezo ke liye typically Angioplasty ki zarurat padti hai. Angioplasty ke results bohot he acche hote hai aur within 6-8 hours hath ekdam normal hojata hai.

Apne dekha hoga ki bohot baar patients ko yeh boldia jata hai ki apka Fistula nahi kia ja sakta. Hum is tarah ki expertise rakhte hai jin patients ko bata dia jata hai ki koi naya Fistula nahi kia ja sakta hai.

So, har wo patients jinhe AV Fistula ke options mana kardia jata hai, unme bhi kuch na kuch AV Fistula ke options bache hue hote hai, ye thode un common hote hai, normal fistula se thodi badi surgery hoti hai. But since AV Fistula ek Dialysis patient ki lifeline hot hai, un patients ke liye in options ko explore karna bohot he important hota hai.

Baisilic vein transposition and AV Graft, ye bohot he common procedure hai jinko in patients me kiya ja sakta hai. Agar aap in patients me se hai jisnke liye AV Fistula ke raste band ho chuke hai, aap hume contact kar sakte hai Lybrate ke through ya fir aap humare centre pe personal appointment ke liye bhi aa sakte hai.