Ultrasonographic maturation of native arteriovenous fistulae: a follow-up study.
OBJECTIVE
Ideal time needed for arteriovenous fistula (AVF) maturation is still controversial. In this study, we aimed to investigate the natural course of AVF maturation and also investigated the factors affecting AVF maturation.


METHODS
We studied 31 (21M/10F, mean age 55.8 +/- 16.2) chronic renal failure patients. We evaluated the patients with color Doppler ultrasound examination before the fistula operation, at the first day, and at the first, second, third, and sixth months. Radial artery (RA) diameter, flow velocity, flow, resistance index, fistula vein diameter, flow velocity, and flow were measured.


RESULTS
Patency rates at the first post-operative day and the sixth month were 87.1% and 67.1%, respectively. Cephalic vein flow was 451.2 +/- 248.6 mL/min at the first month and 528.6 +/- 316.5 mL/min at the sixth month. Baseline RA diameter was lower in failing fistulas than that of patent fistulas. Failing fistulas were more common in women.


CONCLUSIONS
Blood flow was enough for hemodialysis at the end of the first month. However, fistula maturation had continued until the end of the study; women and patients with low RA diameter are particularly prone to fistula failure. Therefore, especially in these patients, AVF must be created at least three or four months before the predicted hemodialysis initiation time.
Seyahi
Nurhan
N
Department of Internal Medicine, Division of Nephrology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey. nseyahi@yahoo.com
Altiparmak
Mehmet R
MR
Tascilar
Koray
K
Pekpak
Meltem
M
Serdengecti
Kamil
K
Erek
Ekrem
E
D001166:Arteriovenous Shunt, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012039:Regional Blood Flow; D006435:Renal Dialysis; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014654:Vascular Patency