Doppler ultrasound and calcification score: improving vascular access surveillance

Renal Failure
Maria Guedes MarquesPedro Ponce

Abstract

Vascular access (VA) dysfunction limits hemodialysis delivery, which increases morbidity and mortality. The most com mon cause of VA failure is thrombosis, due to flow limiting stenosis resulting from neointimal hyperplasia. This occurs not only due to hemodynamic factors but also by systemic ones related to vascular atherosclerosis, inflammation and calcification, which has developed a simple vascular calcification score (SVCS) predictor of vascular calcification and arterial stiffness. The NKF-K/DOQ recommends several diagnostic procedures for VA surveillance. Blood access flow (Qa) has predictive power for the detection of stenosis. Our aim was to evaluate the role of systemic factors, especially SCVS, on Qa. Transversal study in 50 patients. Qa value was obtained with Blood Temperature Monitor and Doppler method. Pearson coefficient evaluated correlation between them. Clinical, lab and radiological variables were recorded and non-parametric tests evaluated how both Qa varied with them. Pearson's corelation between DU-Qa and TD-Qa was 0.851 (p-value <0.001). DU-Qa varied significantly with age (p = 0.012), VA type (p = 0.021), SCVS (p = 0.030), intra-access arterial pressure (p = 0.015) and time on dialysis (p = 0.002). BTM-...Continue Reading

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