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- Title
Blood Flow Surveillance of Hemodialysis Grafts: Insights from Two Case Reports.
- Authors
Atray, Naveen K.; Paulson, William D.
- Abstract
It is widely recommended that all hemodialysis grafts undergo blood flow (Q[SUBa]) surveillance, and that stenosis be corrected when accompanied by a low Q[SUBa] or decrease in Q[SUBa] (ΔQ[SUBa]). This recommendation has, however, become increasingly controversial. Studies have shown that although there is an association between Q[SUBa] and thrombosis, the accuracy of Q[SUBa] in predicting thrombosis within individual patients is poor. We describe two cases that demonstrate common causes of poor predictive accuracy. These cases also show that application of Q[SUBa] surveillance algorithms is often complex and ambiguous. Most studies reporting that surveillance with intervention reduces thrombosis or prolongs graft life have used historical or sequential control groups, or have been retrospective. Accurate assessment of the benefit of graft surveillance must await studies that are fully prospective and randomized with concurrent control groups. Until such studies have demonstrated sufficient benefit, we do not recommend periodic Q[SUBa] surveillance with intervention of all hemodialysis grafts.
- Subjects
HEMODIALYSIS; THROMBOSIS diagnosis
- Publication
Seminars in Dialysis, 2002, Vol 15, Issue 5, p370
- ISSN
0894-0959
- Publication type
Article
- DOI
10.1046/j.1525-139X.2002.00056.x