How early can we start using the AV fistula after surgery?

How early can we start using the AV fistula after surgery?

In general, it is recommended to wait at least 6 weeks after AVF creation before using it for dialysis. During this time, the fistula is allowed to heal and mature, which allows it to develop the necessary blood flow and strength to withstand the repeated needle punctures required for hemodialysis.

The requirements for a AVF to start using are:

Rule of ‘6’ 

  1. Wait for 6 weeks from AV fistula creation
  2. Vein diameter should be at least 6 mm to be able to puncture safely and achieve good flows
  3. 2 puncture points should be at least 6 cm apart to avoid recirculation of blood.
  4. The vein should be not more than 6mm in depth from the skin

These parameters are looked at by the vascular surgeon during the 6th week review after surgery.

It is important to follow the guidance of the vascular surgeon and nephrologist regarding the appropriate timing for using the AVF for dialysis, as using it too early can increase the risk of complications such as bleeding, failure, clotting or infection.

Suggested further reading on AV Fistula

Contact me for any questions or clarification on AV fistula for dialysis access



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I am Dr. Rahul Agarwal resident of Hyderabad with over 18years of experience in medical field.

Department of vascular & Endovascular Surgery,

Intervention Radiology and Podiatric surgery.

Care hospital outpatient centre,

road no 10. Banjara hills. Hyderabad

+91 9160903004


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