Doppler detected opening size and flow chart as predictors of early failure of arteriovenous fistula in hemodialysis patients

ABSTRACT

To determine whether Flow rate and the Size of the opening can predict early failure of arteriovenous fistulae in haemodialysis patients on Doppler ultrasonography. Prospective, quasi experimental study from March 2004 to January 2006. This study was conducted in Surgical "c" ward of the Khyber Teaching Hospital, Preshawar. A total of 92 patients with ESRD [End Stage Renal Disease] who were selected for haemodialysis. All the patients were subjected to Doppler study during the first week of AVF [arteriovenous fistula] construction, and the stomal size and blood flow rate detected. Both these parameters were used as predictors of AVF failure on follow-up visits during the next six months. Out of 92 patients, 13 [14.1%] had an initial stomal opening ranging from 2.3-3.5 mm and 44 [47.8%] from 3.5-5mm, while in 35 [385] patients the opening was > 5 mm. Twenty two [23.9%] patients had an initial flow rate of <400ml/min, 52 [56.5%] 400-700 ml/min and in 18 [19.5%] patients the flow rate was >700 ml/min. During the six months follow-up visits there were 14 [15.3%] AVF failures; all these patients had an initial flow rate of less than 400 ml/min, with a stomal opening of <3 mm in size. Initial stomal opening size and flow rate can be used as good predictors of early Arterio-venous failure in haemodialysis patients on Doppler ultrasonography