Ultrasound dilution evaluation of pediatric hemodialysis vascular access

Goldstein, S.L.; Allsteadt, A.; Goldstein, S.L; Allsteadt, A

doi:10.1046/j.1523-1755.2001.00753.x

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Ultrasound dilution evaluation of pediatric hemodialysis vascular access

Goldstein, S.L.; Allsteadt, A.

Kidney International 59(6): 2357-2360

2001

ISSN/ISBN: 0085-2538

PMID: 11380840

DOI: 10.1046/j.1523-1755.2001.00753.x
Accession: 011608652

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Summary

Background: Hemodialysis access thrombosis is a significant cause of morbidity for hemodialysis patients and results from decreased access flow caused by venous outflow tract stenosis. Ultrasound dilution (UD) is a practical, noninvasive, and reliable indicator of access flow and is effective in predicting venous stenosis in adult patients receiving hemodialysis. Methods: The current study is the first to our knowledge to evaluate the accuracy of UD in predicting hemodialysis access stenosis in a pediatric hemodialysis population. Thirteen pediatric patients receiving hemodialysis via permanent access (4 AVF and 9 AVG) received 73 UD measurements over three months. Results: Mean raw access flow (QA) was 720 +- 428 mL/min, and mean corrected access flow (QAcorr) was 886 +- 537 mL/min/1.73 m2. QAcorr was significantly lower in accesses with stenosis (401 +- 176 mL/min/1.73 m2) versus accesses without stenosis (1158 +- 330 mL/min/1.73 m2, P < 0.0001). Unlike flow values reported by raw QA, there was no overlap in flow values reported by QAcorr in accesses with stenosis (174 to 579 mL/min/1.73 m2) versus accesses without stenosis (709 to 1711 mL/min/1.73 m2). Two patients with an AVG who had QAcorr less than 600 mL/min/1.73 m2 developed an access thrombosis within one week after UD measurement. No patients with QAcorr greater than 700 mL/min/1.73 m2 developed access thrombosis in the 30 days following UD measurement. Conclusions: The current study supports the use of monthly UD measurement to prevent access thrombosis in children receiving hemodialysis.

Ultrasound dilution evaluation of pediatric hemodialysis vascular access

Goldstein, S.L.; Allsteadt, A.

Kidney International 59(6): 2357-2360

2001

Full-Text Article emailed within 0-6 h

Summary

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