The role of Doppler ultrasonography in vascular access surveillance-controversies continue

Chronic hemodialysis therapy required regular entry into the patient's blood stream with adequate flow. The use of arteriovenous fistulas and grafts is linked with lower morbidity and mortality than the use of catheters. However, these types of accesses are frequently affected by stenoses, whic...

Descripción completa

Detalles Bibliográficos
Autores: Malik, Jan|||0000-0002-2386-3293, Lomonte, Carlo, Meola, Mario|||0000-0002-1330-2820, de Bont, Cora|||0000-0003-2176-5275, Shahverdyan, Robert, Rotmans, Joris I.|||0000-0001-9682-6234, Saucy, François, Jemcov, Tamara, Ibeas, Jose|||0000-0002-1292-7271
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:291141
Acceso en línea:https://ddd.uab.cat/record/291141
https://dx.doi.org/urn:doi:10.1177/1129729820928174
Access Level:acceso abierto
Palabra clave:Arteriovenous fistula
Arteriovenous graft
Hemodialysis
Hemodialysis vascular access
Ultrasonography
Descripción
Sumario:Chronic hemodialysis therapy required regular entry into the patient's blood stream with adequate flow. The use of arteriovenous fistulas and grafts is linked with lower morbidity and mortality than the use of catheters. However, these types of accesses are frequently affected by stenoses, which decrease the flow and lead to both inadequate dialysis and access thrombosis. The idea of duplex Doppler ultrasound surveillance is based on the presumption that in-time diagnosis of an asymptomatic significant stenosis and its treatment prolongs access patency. Details of performed trials are conflicting, and current guidelines do not support ultrasound surveillance. This review article summarizes the trials performed and focuses on the reasons of conflicting results. We stress the need of precise standardized criteria of significant access stenosis and the weakness of the metaanalyses performed.