In:
Blood Purification, S. Karger AG, Vol. 20, No. 2 ( 2002), p. 177-181
Abstract:
〈 i 〉 Background/Aim: 〈 /i 〉 The measurement of the vascular access blood flow rate (Q 〈 sub 〉 a 〈 /sub 〉 ) in chronic hemodialyzed patients was proposed to predict access thrombosis. We have recently presented a new method based on the measurements of ionic dialysance at normal and reversed positions of the blood lines. We evaluate the reliability of the measurement of Q 〈 sub 〉 a 〈 /sub 〉 by this method in detecting significant access stenoses. 〈 i 〉 Methods: 〈 /i 〉 Twenty-five patients on chronic hemodialysis and having a vascular access cannulated with two needles were studied. The Q 〈 sub 〉 a 〈 /sub 〉 was evaluated by the Diascan 〈 sup 〉 ® 〈 /sup 〉 ionic dialysance (Q 〈 sub 〉 a-id 〈 /sub 〉 ) method and by the ultrasound dilution technique (Q 〈 sub 〉 a-us 〈 /sub 〉 ; Transonic 〈 sup 〉 ® 〈 /sup 〉 ) during the same dialysis session. The measurements were available for 23 patients. In addition, the patients had ultrasonography of their fistula followed by angiography, if a stenosis was detected. 〈 i 〉 Results: 〈 /i 〉 Q 〈 sub 〉 a-id 〈 /sub 〉 and Q 〈 sub 〉 a-us 〈 /sub 〉 were not significantly different, showing a difference in Q 〈 sub 〉 a 〈 /sub 〉 at 32 ± 469 ml/min. Q 〈 sub 〉 a-id 〈 /sub 〉 was significantly different between patients with or without stenosis (508 ± 241 vs. 1,125 ± 652 ml/min, p 〈 0.05). Among patients with a Q 〈 sub 〉 a 〈 /sub 〉 〈 500 ml/min by Q 〈 sub 〉 a-id 〈 /sub 〉 , 5 had a stenosis detected by ultrasonography (sensitivity 83%), and 3 had no stenosis (false-positive rate 18%). Of these 3 patients, 2 had a thrombotic event at 1 and 3 months, suggesting that a more sensitive detection of stenosis for this range of Q 〈 sub 〉 a 〈 /sub 〉 is needed and that a Q 〈 sub 〉 a 〈 /sub 〉 〈 500 ml/min has a higher power to predict thromboses than a stenosis by ultrasonography. 〈 i 〉 Conclusions: 〈 /i 〉 The measurement of the access flow rate by the Q 〈 sub 〉 a-id 〈 /sub 〉 method has a clinical relevance to the detection of vascular access stenosis. An intervention program based on the Q 〈 sub 〉 a-id 〈 /sub 〉 has to be evaluated.
Type of Medium:
Online Resource
ISSN:
0253-5068
,
1421-9735
Language:
English
Publisher:
S. Karger AG
Publication Date:
2002
detail.hit.zdb_id:
1482025-0
