How to carry out monthly blood flow surveillance of fistula in large-scale hemodialysis units: A cross-sectional study

Abstract

Background: The important effect of regular blood flow surveillance on arteriovenous fistula maintenance is emphasized. The ultrasonic dilution technique for blood flow surveillance can be performed during hemodialysis, but there are some limitations. Blood flow is traditionally measured by duplex Doppler ultrasound during the nondialysis period. However, the surveillance workload for arteriovenous fistula has increased with the rapid increase in the hemodialysis population size. Efficient methods for blood flow surveillance during hemodialysis are needed. Methods: Eighty-four hemodialysis patients with a forearm radiocephalic arteriovenous fistula were enrolled in this cross-sectional study. Each received blood flow measurements using ultrasonic dilution technique and duplex Doppler ultrasound during hemodialysis. Duplex Doppler ultrasound measurements included the blood flow of the brachial artery and radial artery. The correlations between these variables were analyzed. Results: The correlation coefficients ( r) between flow measured by ultrasonic dilution technique and brachial artery flow measured by duplex Doppler ultrasound, between flow measured by ultrasonic dilution technique and radial artery flow measured by duplex Doppler ultrasound, and between brachial artery flow and radial artery flow measured by duplex Doppler ultrasound were 0.724, 0.784, and 0.749, respectively (all p < 0.001). Conclusion: Blood flow measured by ultrasonic dilution technique was positively correlated with blood flow measured by duplex Doppler ultrasound during hemodialysis, suggesting that duplex Doppler ultrasound can be used to monitor the trends in the blood flow of the brachial artery and radial artery for timely intervention to improve patency during hemodialysis.

Validation of a novel ultrasound Doppler monitoring device (earlybird) for measurements of volume flow rate in arteriovenous fistulas for hemodialysis

“…There is good agreement between the methods. [25][26][27] These methods need specialized trained personnel, often require flow reversal during dialysis and can be time consuming. 9 Because of high technical failure-rate and high-cost of dilution techniques, DUS is the recommended method.…”

The impact of vascular access location on pulmonary arterial pressure in chronic kidney disease patients undergoing hemodialysis

“…For measuring access flow, ultrasonic dilution technique is an alternative to Doppler flow measurement. Blood flow measured by Doppler ultrasound is known to correlate positively with ultrasonic dilution technique 23 . This research adhered to the ethical principles of Declaration of Helsinki and was approved by Institutional Ethics Committee.…”

Expert consensus on the establishment and maintenance of native arteriovenous fistula

“…Researchers believe that QA-based Doppler ultrasound monitoring and intervention can reduce the incidence of thrombosis, is cost-effective, and can improve AVF thrombotic events and secondary patency rate. 116 While there are studies that support regular Doppler ultrasonography after AVF maturation, 117,118 some other studies have reached different conclusions. 119 Although the KDOQI guidelines have conservative recommendations for regular Doppler ultrasound examinations, this consensus expert group considers that based on the relatively backward status of China's overall HD level and in order to promote the development of vascular access-related fields, we recommend regular Doppler ultrasound examinations for AVF.…”