How soon before dialysis is started does the fistula need to be put in?

I usually try to have a fistula in place at least 6 months before dialysis is anticipated.  It is often difficult to predict when dialysis may be needed, so I also recommend that when the estimated glomerular filtration rate (eGFR) falls below 20 milliliters per minute per 1.73 meters squared, a fistula should be created.

 

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