RESUMO
A reliable and accurate non-invasive test is needed to help determine grafts and/or fistulae in end-stage renal disease (ESRD) patients. Sonographic scanning to assess the state of the fistula and AV shunt seems underused. To find out what role B-mode and Doppler play in the assessment of fistula and shunt, we scanned nine patients with a fistula as central access and nine patients with a graft several times over a period of a month. Diameters were measured before and after the AV shunt and Doppler measurements were made pre, inter and post shunt. We established that B-mode measurements are reliable in predicting the future and integrity of both fistulae and grafts. Doppler measurements were less consistent and therefore less reliable. The average initial measurement showed a screen of 5.766 mm and a second measurement of 5.890 mm; The coefficient of variation (CV)/reproducibility was 1.58% for first measurement. The average first and second measurements post graft were 6.317 mm and 6.365 mm, respectively. The CV/reproducibility was 0.48%. First and second peak flow measurements averaged 149 m/s and 112 m/s, respectively, resulting in a CV of 14.0%. We conclude that morphological changes may be more reliable than Doppler values, indicating a potentially greater use for B-mode ultrasound in predicting an open shunt and/or fistula.
