Correlation of arteriovenous fistula flow and hemodialysis adequacy

Abstract

The aim of our study was to determine whether there is a relationship of flow through arteriovenous fistula and adequacy of dialysis in patients treated with repeated hemodialysis. The study included 37 patients who were on the program of repeated hemodialysis for more than three months. Patients were divided into two groups according to the flow through the arteriovenous fistula. For each patient, the observed parameters were recorded at baseline and after six months. In both phases of the study, more patients who had reduced flow through the fistula had inadequate dialysis but none of these differences reached statistical significance. The frequency of abnormal values of laboratory parameters was higher in patients who had reduced flow through the fistula, but these differences were not significant in the first phase of the study. Between the two phases of the study in patients with adequate flow through the fistula, there was a reduction in the frequency of pathological values of laboratory parameters, and in the group of the patients with reduced flow rate the frequences remained the same or increased, so that in the second phase of the study the incidence of hypocalcemia was significantly higher in patients with low flow. Satisfactory flow through the vascular access is important, but not decisive factor for good dialysis adequacy and must be viewed within the context of other clinical and laboratory parameters. ApstraktCilj našeg rada bio je da utvrdi da li postoji povezanost protoka kroz arteriovensku fistulu i pokazatelja adekvatnosti dijalize kod pacijenata koji se le e ponovljenim hemodijalizama. Istraživanje je obuhvatilo 37 pacijenata koji su na programu ponavljanih hemodijaliza duže od tri meseca. Pacijenti su bili podeljeni u dve grupe prema protoku kroz arteriovensku fistulu. Za svakog pacijenta posmatrani parametri registrovani su na po etku istraživanja i nakon šest meseci. U obe faze istraživanja, više ispitanika koji su imali smanjen protok kroz fistulu imalo je neadekvatnu dijaliziranost, ali ni jedna od ovih razlika nije dostigla statisti ku zna ajnost. U estalost patoloških vrednosti laboratorijskih parametara bila je ve a kod pacijenata koji su imali snižen protok kroz fistulu, ali ove razlike nisu dostizale statisti ku zna ajnost u prvoj fazi istraživanja. Izme u dve faze istraživanja kod pacijenata sa adekvatnim protokom kroz fistulu došlo je do smanjenja u estalosti patoloških vrednosti laboratorijskih parametara, dok su u estalosti kod pacijenata sa smanjenim protokom ostale iste ili su se pove ale, tako da je u drugoj fazi istraživanja u estalost hipokalcemije bila zna ajno ve a kod pacijenata sa sniženim protokom. Zadovoljavaju i protok kroz vaskularni pristup jeste zna ajan, ali ne i presudan faktor za dobru dijaliziranost i mora se posmatrati u sklopu svih drugih klini kih i laboratorijskih parametara.Klju ne re i: vaskularni pristup, protok kroz arteriovensku fistula, adekvatnost dijalize ORIGINALNI RADOVI ORIGINAL ARTICLES