Renal Ultrasound course - fistula pain question

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Renal Ultrasound course - fistula pain question

Postby xtiand » Sat Nov 17, 2012 7:31 pm

As I mentioned a month ago I was a guinea pig on the renal ultrasound course today and had my fistula scanned by 14 post-grad doctors planning to specialize in renal medicine. The scanning itself was fascinating, seeing the veins and arteries in my arm, watching the blood flow etc, though I was a little unnerved when the tutor mentioned that there is an area of thickening or possible thrombosis in the artery again (I had to have fistula angioplasty earlier this year when the fistula stopped working due to thrombosis) - however he did say that the fistula is still patent and the blood flow sufficient at the moment. I'll need to be vigilant with checking the bruit!
The students were asking about pain in fistula arms and the answer seemed to be that it could be caused by a number of things - a narrowing in the artery/vein resulting in a build up of pressure, the growing vein causing pressure to local nerves,too rapid fluid removal during dialysis, nerve damage during surgery, or steal syndrome. The tutor was saying that there hasn't been much recent research into steal syndrome or fistula pain so it was an area in need of further study.
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