Color Doppler Ultrasound Assessment of Well Functional Arteriovenous Fistulas in Hemodialysis Patients

A well-functioning arteriovenous fistula (AVF) is essential for maintenance of hemodialysis in patients with chronic renal failure. Color Doppler ultrasonography has been proven to be effective in the assessment of anatomical vascular features. The majority of studies were done in patients with clinically presumed AVF complications. However, only limited data are available about the well-functioning mature arteriovenous fistulas. The purpose of the present study was to evaluate completely asymptomatic AVFs with color Doppler ultrasound. In an analytic-descriptive cross-sectional study, 50 patients with clinically well-functioning AVFs were evaluated during a 14-month period in Tabriz Imam Khomeini Hospital. These patients had normal blood pressure and routine serum laboratory factors were within normal range. The AVFs were assessed by color Doppler ultrasound and the flow parameters and probable present complications were investigated. Fifty patients, 30 males and 20 females with a mean age of 51.58±20.27 years were recruited. The mean duration of hemodialysis was 47.88±36.61 months. The mean flow volume was 1009.76±561.84 mL/min. The mean resistive index was 0.51±0.08 in the studied population. The mean pulsative index was 0.89±0.16 with a mean peak systolic velocity of 87.90±33.65 cm/s and a mean diastolic velocity of 56.28±18.36 cm/s. Each aneurysm, stricture and hematoma was present in 4% of the studied AVFs. Overall presence rate of any complication was 12%. Based on our results, color Doppler ultrasound may be used for evaluating the condition and function of the AVFs in patients under hemodialysis. The rate of occult complications in apparently normal-functioning AVFs is considerable and routine screening programs might be helpful.