Physiologic variability of vascular access blood flow for hemodialysis.
OBJECTIVE
To assess the variability of blood flow (QVA) through a native arteriovenous fistula (AVF) in the long-term and to determine the QVA reduction at which an intervention is appropriate.


METHODS
The study was performed in a group of 34 chronic hemodialysis patients with no history of a AVF intervention. QVA was measured using the thermodilution method (Blood Thermodilution Monitor, Fresenius). Median follow-up was 41 months and the median number of QVA measurements in each patient was 15. The coefficient of variation (CV) of QVA was calculated for each patient.


RESULTS
Mean QVA was 904 +/- 334 ml/min. The mean CV was 23.3 +/- 11.2%.


CONCLUSIONS
QVA may fluctuate during a long-term follow-up period. The detection of QVA decrease by 20-25% could be still within physiological limits. Based on the results we recommend to first repeat the measurement at a shorter interval and to refer the patient to a radiologist only when the decreasing trend is confirmed.
Válek
Martin
M
Department of Internal Medicine Strahov, General University Hospital, Prague, Czech Republic. m.valek@seznam.cz
Lopot
Frantisek
F
Dusilová-Sulková
Sylvie
S
Polakovic
Vladimír
V
D000368:Aged; D001164:Arteriovenous Fistula / Q000503:physiopathology* / Q000628:therapy; D001783:Blood Flow Velocity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies