Five years of vascular access stenosis surveillance by blood flow rate measurements during hemodialysis using the Delta-H method
Five years of vascular access stenosis surveillance by blood flow rate measurements during hemodialysis using the Delta-H method
J Vasc Access 2012; 13(3): 321 - 328
DOI:10.5301/jva.5000053
Authors
Ramón Roca-Tey, Rosa Samon, Omar Ibrik, Empar Roda, Juan Carlos González-Oliva, Román Martínez-Cercós, Jordi Viladoms
Abstract
Purpose: To report experience over five years of vascular access (VA) stenosis surveillance. Methods: We prospectively monitored the blood flow rate (QA) of 145 VA in 131 ESRD (age 62.6 ±13.5 y) patients (pts). QA measurement: within the first hour of the hemodialysis (HD) session by the Delta-H method using the Crit Line III Monitor. All VA with baseline QA < 700 mL/min or decreased > 20% from baseline over time met the positive evaluation (PE) criteria and were referred for angiography (AG) plus elective intervention if stenosis = 50%. Results: We found 54 cases of PE in 47 VA; the AG was performed in 87% (47/54) cases of PE and most of them (43/47, positive predictive value: 91.5%) showed significant stenosis (mean degree 80.5 ±12.9%). Mean QA increased from 554.7±107.6 mL/min to 977.9 ± 359.9 mL/min just before versus after preventive intervention (P<.001). Without difference when comparing the highest QA reported before stenosis development (889.8 ± 409.5 mL/min) and the QA recorded just post-intervention (P=.18). Kt/V index: improved from 1.43 ± 0.22 to 1.49 ± 0.21 just before versus after intervention (P=.006). Conclusions: 1) The Delta-H technique is an accurate method for early diagnosis of VA stenosis and is useful in monitoring the hemodynamic effect of elective VA treatment. 2) After preventive intervention for stenosis, functional VA status is restored and HD delivery is improved.
Article History
- • Accepted on 04/12/2011
- • Available online on 23/01/2012
- • Published in print on 28/09/2012
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Authors
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Roca-Tey, Ramón [PubMed] [Google Scholar]
Department of Nephrology, Hospital de Mollet, Universitat Oberta de Catalunya (UOC), Barcelona - Spain
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Samon, Rosa [PubMed] [Google Scholar]
Department of Nephrology, Hospital de Mollet, Universitat Oberta de Catalunya (UOC), Barcelona - Spain
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Ibrik, Omar [PubMed] [Google Scholar]
Department of Nephrology, Hospital de Mollet, Universitat Oberta de Catalunya (UOC), Barcelona - Spain
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Roda, Empar [PubMed] [Google Scholar]
Department of Nephrology, Hospital de Mollet, Universitat Oberta de Catalunya (UOC), Barcelona - Spain
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González-Oliva, Juan Carlos [PubMed] [Google Scholar]
Department of Nephrology, Hospital de Mollet, Universitat Oberta de Catalunya (UOC), Barcelona - Spain
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Martínez-Cercós, Román [PubMed] [Google Scholar]
Department of Vascular Surgery, Hospital de Mollet, Universitat Oberta de Catalunya (UOC), Barcelona - Spain
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Viladoms, Jordi [PubMed] [Google Scholar]
Department of Nephrology, Hospital de Mollet, Universitat Oberta de Catalunya (UOC), Barcelona - Spain