In:
Egyptian Journal of Radiology and Nuclear Medicine, Springer Science and Business Media LLC, Vol. 53, No. 1 ( 2022-10-31)
Abstract:
A well-functioning vascular access is a mainstay to perform an efficient hemodialysis procedure. Limited lifespan of arteriovenous accesses is one of the major challenges of the current long-term hemodialysis therapy. Vascular access-related morbidity accounts for up to 50% of total dialysis patient’s costs. The pediatric vascular access clinical guidelines published by the National Kidney Foundation Kidney Disease Outcome Quality Initiative recommend establishing a surveillance strategy to detect access stenosis and direct patients for early intervention. The aim of this study was to test the role of using the color Doppler ultrasonography (CDU) as a surveillance method for arteriovenous fistulae in children on regular hemodialysis and its value for detecting the early vascular access failure or dysfunction to avoid access loss. Results During 10-month duration, we prospectively conducted surveillance for 30 patients on regular hemodialysis through arteriovenous fistulae (AVF) as a vascular access, clinical assessment of AVF and radiological examination using CDU of the upper limbs. Their ages were ranging from 2 to 18 years with 1:1 male: female ratio. Doppler indices were measured in the afferent arteries, at the site of anastomosis, and the draining veins. AVF stenosis was the highest among all the detected complications ( n = 9, 30%), aneurysm and pseudoaneurysmal formation ( n = 8, 26%) anastomoses diameter reduction in 16.6%, and it was correlated with the dialysis adequacy measured through the Kt/v. Other complications were thrombosis ( n = 2, 6.7%), central venous stenosis ( n = 2, 6.7%), steal syndrome ( n = 1, 3.3%) and calcifications in ( n = 1, 3.3%). In total, 26% of the patients have more than one malfunction. Only one case has access failure a month after CDU examination. Conclusion In conclusion, among pediatric patients CDU can detect early stenosis of AVF in children, which can affect the dialysis adequacy.
Type of Medium:
Online Resource
ISSN:
2090-4762
DOI:
10.1186/s43055-022-00912-y
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2022
detail.hit.zdb_id:
2583928-7
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