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- Title
Ultrasound dilution evaluation of pediatric hemodialysis vascular access.
- Authors
Goldstein, Stuart L.; Allsteadt, Amelia; Goldstein, S L; Allsteadt, A
- Abstract
<bold>Background: </bold>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. <bold>Methods: </bold>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. <bold>Results: </bold>Mean raw access flow (QA) was 720 +/- 428 mL/min, and mean corrected access flow (QAcorr) was 886 +/- 537 mL/min/1.73 m(2). QAcorr was significantly lower in accesses with stenosis (401 +/- 176 mL/min/1.73 m(2)) versus accesses without stenosis (1158 +/- 330 mL/min/1.73 m(2), 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 m(2)) versus accesses without stenosis (709 to 1711 mL/min/1.73 m(2)). Two patients with an AVG who had QAcorr less than 600 mL/min/1.73 m(2) developed an access thrombosis within one week after UD measurement. No patients with QAcorr greater than 700 mL/min/1.73 m(2) developed access thrombosis in the 30 days following UD measurement. <bold>Conclusions: </bold>: The current study supports the use of monthly UD measurement to prevent access thrombosis in children receiving hemodialysis.
- Subjects
HEMODIALYSIS; ARTERIOVENOUS fistula
- Publication
Kidney International, 2001, Vol 59, Issue 6, p2357
- ISSN
0085-2538
- Publication type
journal article
- DOI
10.1046/j.1523-1755.2001.00753.x