title: Hemodialysis access flow measurement. Comparison of ultrasound dilution and duplex ultrasonography.
abstract: Decreased hemodialysis access flow is associated with an increased risk of access thrombosis. Duplex ultrasonography can measure access flow and select a subset of patients at increased risk for access failure. With in-line techniques (ultrasound dilution), access flow can be measured during hemodialysis. This study attempted to determine if access flow measured by ultrasound dilution (QA-T) was comparable to that measured by duplex ultrasonography (QA-S). The authors performed 66 simultaneous measurements of hemodialysis access flow in 19 patients by ultrasound dilution and duplex ultrasound with time-domain correlation during 19 hemodialysis treatments. The mean access flow was 1,086 +/- 505 ml/min by ultrasound dilution and 1,026 +/- 513 ml/min with duplex ultrasonography (NS). Regression analysis revealed a linear relationship between the two techniques described by the equation QAT = 246.14 + 0.8104(QAS) (correlation coefficient of 0.83; p < 0.0001). Measurement of hemodialysis access flow by ultrasound dilution was essentially equivalent to that obtained by duplex ultrasound. Additional studies are needed to determine if regular in-line flow measurements can predict and prevent future access thrombosis and decreased the cost of access management.
authors.affiliation: Renal Consultants of Wyoming Valley, Professional Corporation, Wilkes-Barre Pennsylvania, USA.
authors.forename: J
authors.initials: J
authors.lastname: Sands
authors.forename: D
authors.initials: D
authors.lastname: Glidden
authors.forename: C
authors.initials: C
authors.lastname: Miranda
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D001783:Blood Flow Velocity; D002408:Catheters, Indwelling / Q000009:adverse effects; D005069:Evaluation Studies as Topic; D006439:Hemodynamics; D006801:Humans; D007201:Indicator Dilution Techniques; D011138:Polytetrafluoroethylene; D006435:Renal Dialysis / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D014463:Ultrasonography
chemical_list: D011138:Polytetrafluoroethylene