title: Is ionic dialysance useful for early detection of vascular access dysfunction? Six illustrative cases.
abstract: Continuous ionic dialysance monitoring is a useful clinical tool to determine the dialysis dose in real time in each hemodialysis session. We followed up 49 patients for 16 months. Six patients with a Kt reduction of ≥20% in >3 consecutive hemodialysis sessions were identified. Fistulography demonstrated significant stenosis in all 6 patients. Angioplasty was performed in 5 with an excellent angiographic result and optimal Kt levels were restored. Unexplained and persistent Kt reduction in patients with stable chronic kidney disease under hemodialysis could represent, together with an accurate vascular access examination, a practical and additional indirect method for the early detection of vascular access dysfunction.
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Néstor
authors.initials: N
authors.lastname: Fontseré
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Blasco
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Arias
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Maduell
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Vera
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Burrel
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Barrufet
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Real
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Gaspar
authors.initials: G
authors.lastname: Mestres
authors.affiliation: Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Campistol
mesh_terms: D000368:Aged; D015314:Dialysis Solutions / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007477:Ions; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D062666:Vascular Access Devices / Q000706:statistics & numerical data*
chemical_list: D015314:Dialysis Solutions; D007477:Ions