American Journal of Internal Medicine

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Evaluation Value of Portable Color Doppler Ultrasound for Arteriovenous Fistula Stenosis in Patients with Maintenance Hemodialysis

Received: Apr. 23, 2020    Accepted: May 15, 2020    Published: May 28, 2020
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Abstract

Objective: By comparing the evaluation effect of traditional physical examination (PE) and portable color Doppler ultrasound on arteriovenous fistula (AVF), to explore the value of portable ultrasound in the diagnosis of abnormal fistula lesions in patients with maintenance hemodialysis (HD). Methods: 57 patients with maintenance HD from Dongpu HD center, the first affiliated hospital of Jinan university from September 2019 to March 2020 were selected. The PE was performed by specialist nurses, and AVF was evaluated by portable ultrasound, and the general data of the patients were collected. Results: The average age of the HD patients was 58.98 years, including 31 males (54.39%). The median of HD duration was 56 months, and 22 patients (28.60%) had diabetes mellitus. The prevalence of fistula stenosis was 17.54%. 50% PE was abnormal in fistula stenosis group, which was higher than that in non-fistula stenosis group (10.64%, P=0.012). The κ index was 0.394 in the consistency assessment between PE and portable ultrasound for evaluating the fistula stenosis (P=0.003). The incidence of fistula sound reduction, blood flow less than 200mL/min during treatment and abnormal arm lifting test in patients with fistula stenosis were all higher than those without fistula stenosis (all P<0.05). The results of multivariate logistic regression analysis showed that abnormal PE was closely related to fistula stenosis (OR=8.400, 95% confidence interval (CI)=1.786-39.498, P=0.007). Conclusion: Portable color Doppler ultrasound could effectively diagnose AVF stenosis in maintenance HD patients, especially when the traditional PE was abnormal, timely portable ultrasound evaluation was conducive to early intervention and extend the life of AVF.

DOI 10.11648/j.ajim.20200804.11
Published in American Journal of Internal Medicine ( Volume 8, Issue 4, July 2020 )
Page(s) 143-147
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Hemodialysis, Arteriovenous Fistula, Stenosis, Physical Examination, Ultrasound

References
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[2] Stenvinkel P. Chronic kidney disease: a public health priority and harbinger of premature cardiovascular disease [J]. J INTERN MED, 2010, 268 (5): 456-467.
[3] Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey [J]. LANCET, 2012, 379 (9818): 815-822.
[4] Gökhan I, Ertap E, Sahin B, et al. The Clinical Utility of Vascular Mapping With Doppler Ultrasound Prior to Arteriovenous Fistula Construction for Hemodialysis Access [J]. J Vasc Access, 2013, 14 (1), 83-88.
[5] Timmy L, Joyce Q, Mae T, et al. Tradeoffs in Vascular Access Selection in Elderly Patients Initiating Hemodialysis with a Catheter. Am J Kidney Dis. 2018, 72 (4): 509-518.
[6] McGrogan DG, Maxwell AP, Khawaja AZ, et al. Current tools for prediction of arteriovenous fistula outcomes. Clin Kidney J. 2015; 8 (3): 282–289.
[7] Yevzlin AS, Chan MR, Asif A. Hand Ischemia in a Patient With an Arteriovenous Fistula [J]. Am J Kidney Dis, 2016, 67 (3): 512-515.
[8] Jalandhara N, Balamuthusamy S, Skaria S, et al. Persistent Median Artery As A Cause Of Nonmaturing AVFistula [J]. Semin Dial, 2015, 28 (5): 552-557.
[9] Jamil M, Usman R. Predictive parameters for successful functional maturation of native arteriovenous fistula [J]. J Ayub Med Coll Abbottabad, 2015, 27 (4): 821-824.
[10] Masengu A, McDaid J, Maxwell AP, et al. Preoperative radial artery volume flow is predictive ofarteriovenous fistula outcomes [J]. J Vasc Surg, 2016, 63 (2): 429-435.
[11] Renaud CJ, Leong CR, Bin HW, et al. Effect of brachial plexus block-driven vascular access planning on primary distal arteriovenous fistula recruitment and outcomes [J]. J Vasc Surg, 2015, 62 (5): 1266-1272.
[12] Jones RG, Inston NG, Brown T. Arteriovenous fistula salvage utilizing a hybrid vascular graft [J]. J Vasc Access, 2014, 15 (2): 135-137.
[13] Moore LW, Byham-Gray LD, Scott Parrott J, et al. The mean protein intake at different stages of chronic kidney disease is higher than current guidelines [J]. Kidney Int, 2013, 83 (4): 724-732.
[14] Tanner NC, da Silva AF. Medical Adjuvant Treatment to Improve the Patency of Arteriovenous Fistulae and Grafts: A Systematic Review and Meta-analysis [J]. Eur J Vasc Endovasc Surg, 2016, 52 (2): 243-252.
[15] Lomonte C, Meola M, Petrucci I, et al. The key role of color Doppler ultrasound in the work-up of hemodialysis vascular access [J]. Semin Dial, 2015, 28 (2): 211-215.
[16] Miller PE, Tolwani A, Luscy CP, et al. Predictors of adequacy of arteriovenous fistulas in hemodialysis patients. Kidney Int. 1999 Jul; 56 (1): 275-280.
[17] Charmaine E Lok, Michael Allon, Louise Moist, et al. Risk equation determine unsuccessful communication events and failure to maturation in arteriovenous fistulas (REDUCE FTM I). J Am Soc Nephrol, 2006, 17 (11): 3204-3212.
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    Sujuan Wu, Lingjun Shen, Wenyu Gong. (2020). Evaluation Value of Portable Color Doppler Ultrasound for Arteriovenous Fistula Stenosis in Patients with Maintenance Hemodialysis. American Journal of Internal Medicine, 8(4), 143-147. https://doi.org/10.11648/j.ajim.20200804.11

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    ACS Style

    Sujuan Wu; Lingjun Shen; Wenyu Gong. Evaluation Value of Portable Color Doppler Ultrasound for Arteriovenous Fistula Stenosis in Patients with Maintenance Hemodialysis. Am. J. Intern. Med. 2020, 8(4), 143-147. doi: 10.11648/j.ajim.20200804.11

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    AMA Style

    Sujuan Wu, Lingjun Shen, Wenyu Gong. Evaluation Value of Portable Color Doppler Ultrasound for Arteriovenous Fistula Stenosis in Patients with Maintenance Hemodialysis. Am J Intern Med. 2020;8(4):143-147. doi: 10.11648/j.ajim.20200804.11

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  • @article{10.11648/j.ajim.20200804.11,
      author = {Sujuan Wu and Lingjun Shen and Wenyu Gong},
      title = {Evaluation Value of Portable Color Doppler Ultrasound for Arteriovenous Fistula Stenosis in Patients with Maintenance Hemodialysis},
      journal = {American Journal of Internal Medicine},
      volume = {8},
      number = {4},
      pages = {143-147},
      doi = {10.11648/j.ajim.20200804.11},
      url = {https://doi.org/10.11648/j.ajim.20200804.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajim.20200804.11},
      abstract = {Objective: By comparing the evaluation effect of traditional physical examination (PE) and portable color Doppler ultrasound on arteriovenous fistula (AVF), to explore the value of portable ultrasound in the diagnosis of abnormal fistula lesions in patients with maintenance hemodialysis (HD). Methods: 57 patients with maintenance HD from Dongpu HD center, the first affiliated hospital of Jinan university from September 2019 to March 2020 were selected. The PE was performed by specialist nurses, and AVF was evaluated by portable ultrasound, and the general data of the patients were collected. Results: The average age of the HD patients was 58.98 years, including 31 males (54.39%). The median of HD duration was 56 months, and 22 patients (28.60%) had diabetes mellitus. The prevalence of fistula stenosis was 17.54%. 50% PE was abnormal in fistula stenosis group, which was higher than that in non-fistula stenosis group (10.64%, P=0.012). The κ index was 0.394 in the consistency assessment between PE and portable ultrasound for evaluating the fistula stenosis (P=0.003). The incidence of fistula sound reduction, blood flow less than 200mL/min during treatment and abnormal arm lifting test in patients with fistula stenosis were all higher than those without fistula stenosis (all P<0.05). The results of multivariate logistic regression analysis showed that abnormal PE was closely related to fistula stenosis (OR=8.400, 95% confidence interval (CI)=1.786-39.498, P=0.007). Conclusion: Portable color Doppler ultrasound could effectively diagnose AVF stenosis in maintenance HD patients, especially when the traditional PE was abnormal, timely portable ultrasound evaluation was conducive to early intervention and extend the life of AVF.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Evaluation Value of Portable Color Doppler Ultrasound for Arteriovenous Fistula Stenosis in Patients with Maintenance Hemodialysis
    AU  - Sujuan Wu
    AU  - Lingjun Shen
    AU  - Wenyu Gong
    Y1  - 2020/05/28
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajim.20200804.11
    DO  - 10.11648/j.ajim.20200804.11
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 143
    EP  - 147
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20200804.11
    AB  - Objective: By comparing the evaluation effect of traditional physical examination (PE) and portable color Doppler ultrasound on arteriovenous fistula (AVF), to explore the value of portable ultrasound in the diagnosis of abnormal fistula lesions in patients with maintenance hemodialysis (HD). Methods: 57 patients with maintenance HD from Dongpu HD center, the first affiliated hospital of Jinan university from September 2019 to March 2020 were selected. The PE was performed by specialist nurses, and AVF was evaluated by portable ultrasound, and the general data of the patients were collected. Results: The average age of the HD patients was 58.98 years, including 31 males (54.39%). The median of HD duration was 56 months, and 22 patients (28.60%) had diabetes mellitus. The prevalence of fistula stenosis was 17.54%. 50% PE was abnormal in fistula stenosis group, which was higher than that in non-fistula stenosis group (10.64%, P=0.012). The κ index was 0.394 in the consistency assessment between PE and portable ultrasound for evaluating the fistula stenosis (P=0.003). The incidence of fistula sound reduction, blood flow less than 200mL/min during treatment and abnormal arm lifting test in patients with fistula stenosis were all higher than those without fistula stenosis (all P<0.05). The results of multivariate logistic regression analysis showed that abnormal PE was closely related to fistula stenosis (OR=8.400, 95% confidence interval (CI)=1.786-39.498, P=0.007). Conclusion: Portable color Doppler ultrasound could effectively diagnose AVF stenosis in maintenance HD patients, especially when the traditional PE was abnormal, timely portable ultrasound evaluation was conducive to early intervention and extend the life of AVF.
    VL  - 8
    IS  - 4
    ER  - 

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Author Information
  • Department of Dongpu Hemodialysis Center, Dongpu Branch of the First Affiliated Hospital, Jinan University, Guangzhou, China

  • Department of Dongpu Hemodialysis Center, Dongpu Branch of the First Affiliated Hospital, Jinan University, Guangzhou, China

  • Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, China

  • Section