Venous stenosis in chronic dialysis patients with a well-functioning arteriovenous fistula.
OBJECTIVE
It is not clear whether patient who is dialyzing with a well-functioning vascular access may appear venous stenosis. The aim is to see the prevalence of central or other vein stenoses/occlusions in patients with asymptomatic, normal functioning fistulas.


METHODS
A total of 54 patients met the inclusion criteria. We performed angiography examinations for these patients and reviewed venography of the superficial and deep venous systems.


RESULTS
Among these patients, 21 (39%) were detected positive cases by the angiography, the remainder was negative cases. Thirteen of 54 (24%) had mild central venous stenosis (stenosis <50% diameter with or without collateral branch), 7/54 (13%) had upper arm vein system occlusion or stenosis, another one had anastomotic stenosis. There were no differences in fistula flow dynamics between those with venous abnormalities and those without such as blood flow rate, venous pressures, brachial arterial velocity, and brachial arterial flow rate. We also observed no significant differences in other variables between these two groups (including BMI, hemoglobin, albumin, gender, primary disease, URR, spKt/V P > 0.05).


CONCLUSIONS
The frequency of venous lesion is not low in hemodialysis patients with a well-functioning AVF. To value the impact of these abnormalities on access, prognosis needs longer time follow-up.
Vascular Surgery Department, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Yaxue
Y
Shi
Renal Department, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China millionzhu525@126.com.
Mingli
M
Zhu
Radiology Department, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Jiejun
J
Cheng
Vascular Surgery Department, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Jiwei
J
Zhang
Renal Department, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Zhaohui
Z
Ni
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D003097:Collateral Circulation; D003251:Constriction, Pathologic; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012039:Regional Blood Flow; D006435:Renal Dialysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology*
Angiography; hemodialysis; venous stenosis; well-functioning arteriovenous fistula