Comparison of measures for prospective identification of venous stenoses.
OBJECTIVE
To compare two methods, venous dialysis pressure (VDP) and intra-access static flow pressure (VPO), for the prospective identification of venous stenoses in high-risk PTFE grafts.


METHODS
Comparative.


METHODS
Twenty patients with upper extremity loop grafts in an outpatient chronic hemodialysis population.


METHODS
VDP and VPO were measured for three consecutive treatments within subjects followed by angiography. VDP > 150 mmHg/200 ml/min, VPO > 0.40, and stenoses > 50% were considered positive findings.


RESULTS
In paired t-tests, VPO identified elevated venous pressure more frequently than VDP in patients positive on angiography (mean difference = 77.8%, p < 0.0001). Frequency analysis yielded a sensitivity of 36% for VDP and 93% for VPO (p < 0.05).


CONCLUSIONS
This study found that while VDP is the simpler method to use, VPO is significantly more accurate at predicting venous stenoses.
Dinwiddie
L C
LC
School of Medicine, Division of Nephrology, University of North Carolina, Chapel Hill, USA.
Frauman
A C
AC
Jaques
P F
PF
Mauro
M A
MA
Hogan
S L
SL
Falk
R J
RJ
D000328:Adult; D000368:Aged; D000792:Angiography; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001795:Blood Pressure Determination / Q000379:methods*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D006435:Renal Dialysis / Q000295:instrumentation*; D015203:Reproducibility of Results; D013927:Thrombosis / Q000175:diagnosis*
D011138:Polytetrafluoroethylene