Study of vascular access blood flow by angiodynography.
Angiodynography has been recommended as a safe and accurate way to determine the blood flow through hemodialysis vascular grafts. This information might be used prophylactically to avert total graft occlusion. We examined the blood flows obtained by this technique after an interval of 6 months in a group of hemodialysis patients whose grafts did not require surgical or radiologic manipulation in the interim. No changes in the mean blood flows were noted during the period of observation. Although a significant correlation was found between the original and follow-up blood flows, the coefficient of determination was only 0.27. The Bland-Altman plot of these data showed that both large decreases and increases in graft flows were recorded for many patients whose graft function did not appear to worsen. Dialysis itself did not seem to alter the measured blood flow. We conclude that caution must be used in interpreting changes in blood flow measured over time by angiodynography. More study of the factors accounting for the variability in blood flow estimations by this technique are needed.
Kirschbaum
B
B
Department of Medicine, Medical College of Virginia, Richmond 23298.
Compton
A
A
D000704:Analysis of Variance; D001166:Arteriovenous Shunt, Surgical; D001783:Blood Flow Velocity; D006801:Humans; D016014:Linear Models; D006435:Renal Dialysis; D015203:Reproducibility of Results; D018615:Ultrasonography, Doppler, Color