Surveillance of fistula function by frequent recirculation measurements during high efficiency dialysis.


Journal Article

Native fistulae are assumed to remain patent even with low access flows and are likely to cause access recirculation in high efficiency treatments done with high extracorporeal blood flows. We tested whether frequent recirculation measurements could be used to identify fistulae at risk to fail because of low access flow. High efficiency hemodialysis was delivered by 2008H machines equipped with blood temperature monitors (BTM) to measure recirculation within the first hour of every hemodialysis treatment. Access flow was measured when two consecutive BTM recirculation measurements exceeded a threshold of 15%. If access flow was < 500 ml/min, patients were referred for fistula revision. Eighty patients with native AV fistulae were studied for a period of 6 months. Nine of 11 interventions performed during the whole observation period were triggered by a BTM recirculation above the threshold. Two fistulae thrombosed in spite of a BTM recirculation below the threshold. One fistula with a BTM recirculation above the threshold had an access flow of 1,550 ml/min and was not referred for revision. BTM recirculation to detect fistulae for revision is sensitive (81.8%) and specific (98.6%) in the presence of cardiopulmonary recirculation and can be done with minimum intervention and without loss of efficient treatment time.

Full Text

Duke Authors

Cited Authors

  • Wang, E; Schneditz, D; Ronco, C; Levin, NW

Published Date

  • July 2002

Published In

Volume / Issue

  • 48 / 4

Start / End Page

  • 394 - 397

PubMed ID

  • 12141470

Pubmed Central ID

  • 12141470

International Standard Serial Number (ISSN)

  • 1058-2916


  • eng

Conference Location

  • United States