Arteriovenous fistula stenosis hemodialysis,
Conditions
Interventions
The ultrasound dilution technique utilized the Transonic HD Monitor. The measurement was taken twice within 30 – 60 minutes after HD initiation. Ultrafiltration was turned off during measurement. Th
arterial (a) and venous (v) samples were drawn at a blood flow rate (Qb) of 350 – 400 mL/min,
and the systemic (s) sample was drawn from the arterial tubing after the blood pump was stopped. Blood urea nitrogen concentrations were measured in all samples. The recirculation (R) and access flow
BUNa))/(BUNs-
BUNv))
Qa =BPF × ((1-
R))/R
,Nephrologist and Radiologist performed color Doppler ultrasonography at a different time. A7-
15 MHz linear transducer was used. Peak systolic velocity and AVF diameter were measured at the anastomosis,
juxta-
anastomosis,
body,
and outflow site of the AVF. Access flow (Qa) was calculated as follow:
Access flow (mL/min) = Time-
averaged mean velocity × π × radius2 × 60
The mean access flow value of the two results was used. The operator dependence of the Qa measurement was evaluated by comparing the intra-
assay coefficient of variation
ultrasound dilution,urea dilution,Doppler ultrasonography
Sponsors
Siriraj hospital Mahidol university
Routine to research unit,
Siriraj
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.patients who had features of AVF stenosis (i.e., include limb edema, loss of AVF collapse after arm elevation) 2.high venous pressures of over 200 mmHg on three consecutive HD runs. 3. patients with the other dialysis parameters were also reviewed for additional evidence (i.e., unexplained hemodialysis inadequacy, difficulty needling).
Exclusion criteria
Exclusion criteria: 1. patient who does not want to participate in the trial. 2. patient who could not proceed on all investigations.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| sensitivity of three methods to detect AVF stenosis compare with gold standard ( fistulography) ultrasound dilution, urea dilution, and Doppler ultrasonography | — |
Secondary
| Measure | Time frame |
|---|---|
| sensitivity of venous pressure and physical examination for detect AVF stenosis compare with gold standard (fistulography) sensitivity and specificity | — |
Contacts
Public ContactSukit Raksasuk
nephrology division, faculty of medicine, Siriraj hospital
Outcome results
None listed