Accuracy of doppler ultrasonography in the evaluation of hemodialysis arteriovenous fistula maturity

Abstract

<sec><title>OBJECTIVE:</title><p> to determine the accuracy of Doppler ultrasonography (USD) for hemodialysis arteriovenous fistula (AVF) maturity.</p></sec><sec><title>METHODS:</title><p> we included patients with no prior AVF. Each patient underwent two USD examinations. After initiation of hemodialysis, we followed the patients during the first month of the access use and verified its adequacy to hemodialysis sessions. At statistical analysis we measured specificity, sensitivity, accuracy, ROC curve (Receiver operator characteristic) curve, TG-ROC (Two graph - receiver operator characteristic) and logistic regression.</p></sec><sec><title>RESULTS:</title><p> we included 76 patients, of which 51 completed the study. They formed two groups, those who have had good adequacy for hemodialysis (45) and those who had not (6). The average flow volume (FV) and the average draining vein diameter (DVD) of each group were, respectively: 940mL/min (95% CI: 829-1052) and 325mL/min (95% CI: 140-510); and 0.48cm (95% CI: 0.45-0.52) and 0.33cm (95% CI: 0.27-0.40). The area under the ROC curve of FV and DVD were 0.926 and 0.766, respectively.</p></sec><sec><title>CONCLUSION:</title><p> the accuracy of the measured volume flow measured at the draining vein to evaluate maturation of hemodialysis arteriovenous fistula was 85%.</p></sec>

Ultrasound-guided percutaneous transluminal angioplasty in the treatment of autologous arteriovenous fistula and its prognostic factors

“…It also more accurately determines the exact location, extent and true cause of AVF stenosis. Determining the type of AVF stenosis is more conducive to select the effective intervention methods, so that patients with AVF can restore stula function and undergo hemodialysis in a short time [24,25] . In addition, intraoperative ultrasound can guide puncture and catheterization to evaluate blood ow and PTA effect in real time, reduce the risk and time of surgery and reduce the possibility of intraoperative complications.…”

Patient-related factors influencing patency of autogenous brachiocephalic haemodialysis fistulas

“…Following creation of the BCAVF, a stringent and proactive follow-up schedule was adhered to aimed at monitoring fistula maturation, this is in accordance with previous research addressing vascular access management (22). Four weeks following surgery, clinical assessment and duplex ultrasonography complemented with flow and pressure measurements of arm, hand, and finger were performed (23). When adequate fistula maturation was perceived at this stage follow-up was continued.…”

Frequency of Dysfunctional Arteriovenous Fistula among End Stage Renal Disease Patients on Thrice Weekly Maintenance Hemodialysis

“…In a review in Iran, 69 patients with asymptomatic well-working hemodialysis access were surveyed with Doppler ultrasound. There was a significant degree of anomalies, particularly high blood flow rates in clinically wellworking mature AVFs 10 . Many studies have proved the superiority of DU as compared to clinical examination for the detection of access complications, but clinical examination remains a preferred and mandatory part of AVF complications assessment.…”