A fistula needs to be made about 8 weeks, or sometimes longer, before haemodialysis starts, to allow time for it to develop and get strong enough.

The procedure takes place at your child’s paediatric renal unit, a specialised unit for babies, children and young people with kidney conditions, which may be in a different hospital, and is usually done by a surgeon (this may be a transplant surgeon or a vascular surgeon – who specialises in surgery on blood vessels) or by an interventional radiologist. It usually takes about 2 hours, though your child will probably stay in the hospital for at least one night to recover. You can bring a change of clothes and some toys and books. 

Tests before surgery

Your child may need one of the following imaging tests, to look at his or her blood vessels. This checks whether the blood vessels are too narrow, and helps to select the best vessels to form a fistula. There are a few types of tests, including the following:

  • Venogram:  in this type of  X-ray test, a special dye is injected into one of the veins in your child’s hand. As the dye passes through the veins that lead to the heart, a series of X-ray images (pictures) are taken. 
  • Duplex ultrasonography (or duplex scan): in this type of ultrasound scan, a small handheld device is moved around your child's skin, and uses sound waves (ultrasound) to create images of the blood vessels and how blood is flowing through them.

Preparing for surgery

Your child will be given a general anaesthetic, special medicine so he or she can sleep through the procedure and not feel any pain. The anaesthetist will speak to you about the best option for your child. You will be asked to give written consent, or permission, for the surgery.

What happens 

Your child will be moved into an operating theatre, a room where surgery takes place.

The general anaesthesia will be given as an injection or breathed in. When your child is asleep, the surgeon will make a small cut in your child’s arm – this is usually in the inside of the wrist or elbow.

Your child may be given antibiotic medicines to prevent infection.

After the surgery

Your child will go back to the ward, where he or she will be monitored by a healthcare team – this may be for one or two days, or longer. He or she will have a dressing over the cut. 

Your child may feel some effects from the anaesthesia, but these do not usually last long. They include feeling sick and being sick (vomiting), headache, sore throat, or feeling dizzy or light-headed.