Dialysis fistulas always require surgery, because they connect arteries to veins, according to DaVita. Arteriovenous fistulas are created from parts of the body, and they mature in the body after becoming attached surgically. The maturing process can take months before a patient's fistula is strong enough to use for dialysis.
Fistulas created through surgery provide the best vascular access, as DaVita explains. Using arteriovenous fistulas minimizes episodes of clotting, infection and other complications. Mature fistulas decrease treatment time, because the connected vein enlarges and allows more blood to flow. Fistulas stay functional for long periods of time, often for decades.