Doppler Ultrasound in Vascular Access care: the pearls and pitfalls of flow volume measurement

Abstract

Recently, the European Renal Best Practice (ERBP) clinical practice guidelines on hemodialysis VA stated that the evidence for surveillance in addition to clinical monitoring is inconclusive 11. Still, DUS Qa measurement is a very useful tool in vascular access care that is being increasingly adopted by nephrologists in their daily clinical practice. All the clinicians involved in VA care should be familiar with its advantages, disadvantages, and potential pitfalls, as well as its reliability and correlation with other methods in chronic kidney disease patients. DUPLEX ULTRASOUND-THEORY AND TECHNICAL CONSIDERATIONS Ultrasound is an imaging technique that allows the investigation of the VA through the use of a transducer capable of emitting and receiving ultrasounds and converting them to an electrical signal. This signal is analyzed by a processor and, based on the amplitude of the signal received, a gray-scale image is displayed on the screen of the ultrasound machine 12. The use of Doppler ultrasound for the detection of blood flow in the hemodialysis VA was reported for the first time in 1971, following the increasing use of the Doppler ultrasonic flowmeter as an adjuvant in the diagnosis and management of vascular disease at the time 13. The simplest and most widely available method

Acute hemodynamic changes during far infrared treatment of the arteriovenous fistula in hemodialysis patients

“…21,22 However, Color Doppler Ultrasound and Duplex ultrasound are limited by the fact that they cannot be conducted during HD and may be more investigator dependent. 23…”