How is a mature fistula characterized in hemodialysis practice?

A mature fistula in hemodialysis practice is characterized by its ability to tolerate prescribed maximum gauge and blood flow rate for a specific duration of treatments, typically at least six. This demonstrates that the fistula has developed sufficient diameter and strength to support the increased pressures and flow rates necessary for effective dialysis treatment. The maturation process involves physiological changes in the blood vessels, which may take time and should be monitored closely by healthcare providers. A fistula that meets this criterion indicates that it is functioning well and is suitable for use, maximizing patient safety and treatment efficacy.

While the other characteristics mentioned are relevant to the use and establishment of a fistula, they do not fully encapsulate the appropriate definition of maturity as understood in the context of hemodialysis practice. For instance, merely having a fistula established for over a year does not guarantee its functionality or suitability for high-flow dialysis, and being used exclusively for arterial access does not determine maturity either. Similarly, being cannulated once without issues does not provide a comprehensive view of the fistula's overall functionality.