Hemodialysis Access Surveillance: A Review of the Literature

Vascular access (VA) care is considered the “Achilles heel” for the success of hemodialysis operation. Early detection of VA stenosis remains a major challenge for clinical nephrologists. Various studies tried to create methods with robust accuracy for assessing VA blood flow. It is estimated that r...

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Main Authors: Atif Ibrahim, Hatem Ali, Hafiz Raza, Mahmoud Mohamed
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Saudi Journal of Kidney Diseases and Transplantation
Online Access:http://www.sjkdt.org/article.asp?issn=1319-2442;year=2022;volume=33;issue=7;spage=66;epage=76;aulast=Ibrahim
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author Atif Ibrahim
Hatem Ali
Hafiz Raza
Mahmoud Mohamed
author_facet Atif Ibrahim
Hatem Ali
Hafiz Raza
Mahmoud Mohamed
author_sort Atif Ibrahim
collection DOAJ
description Vascular access (VA) care is considered the “Achilles heel” for the success of hemodialysis operation. Early detection of VA stenosis remains a major challenge for clinical nephrologists. Various studies tried to create methods with robust accuracy for assessing VA blood flow. It is estimated that roughly 80% of VAs fail due to thrombosis. Failure to provide patients with one is a common factor leading to significant morbidity and mortality among hemodialysis (HD) patients with an estimated annual cost around 1 billion US dollars. In the following, we have attempted to review all the available trials and meta-analysis done to date to assess the true effect of VA blood flow monitoring for the purpose of early detection of thrombosis and over-minimizing the rate of intervention. A thorough and systematic search for the available literature was done on several databases such as MEDLINE, EMBASE, Cochrane library and reviewed clinical trials.gov to look for studies involving dialysis access blood flow measurement. We also reviewed the available randomized control trials and meta-analysis done on this subject so far, and the results have a variable outcome. We concluded that arteriovenous access blood flow surveillance using non-invasive ultrasound dilution and Doppler ultrasound methods in detecting stenosis may have a vital and crucial role in lowering the risk of thrombosis, promoting early management and increasing access survival.
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spelling doaj.art-64e7fefb2d83459dabd912803c23ed412023-07-21T13:05:40ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422022-01-01337667610.4103/1319-2442.367827Hemodialysis Access Surveillance: A Review of the LiteratureAtif IbrahimHatem AliHafiz RazaMahmoud MohamedVascular access (VA) care is considered the “Achilles heel” for the success of hemodialysis operation. Early detection of VA stenosis remains a major challenge for clinical nephrologists. Various studies tried to create methods with robust accuracy for assessing VA blood flow. It is estimated that roughly 80% of VAs fail due to thrombosis. Failure to provide patients with one is a common factor leading to significant morbidity and mortality among hemodialysis (HD) patients with an estimated annual cost around 1 billion US dollars. In the following, we have attempted to review all the available trials and meta-analysis done to date to assess the true effect of VA blood flow monitoring for the purpose of early detection of thrombosis and over-minimizing the rate of intervention. A thorough and systematic search for the available literature was done on several databases such as MEDLINE, EMBASE, Cochrane library and reviewed clinical trials.gov to look for studies involving dialysis access blood flow measurement. We also reviewed the available randomized control trials and meta-analysis done on this subject so far, and the results have a variable outcome. We concluded that arteriovenous access blood flow surveillance using non-invasive ultrasound dilution and Doppler ultrasound methods in detecting stenosis may have a vital and crucial role in lowering the risk of thrombosis, promoting early management and increasing access survival.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2022;volume=33;issue=7;spage=66;epage=76;aulast=Ibrahim
spellingShingle Atif Ibrahim
Hatem Ali
Hafiz Raza
Mahmoud Mohamed
Hemodialysis Access Surveillance: A Review of the Literature
Saudi Journal of Kidney Diseases and Transplantation
title Hemodialysis Access Surveillance: A Review of the Literature
title_full Hemodialysis Access Surveillance: A Review of the Literature
title_fullStr Hemodialysis Access Surveillance: A Review of the Literature
title_full_unstemmed Hemodialysis Access Surveillance: A Review of the Literature
title_short Hemodialysis Access Surveillance: A Review of the Literature
title_sort hemodialysis access surveillance a review of the literature
url http://www.sjkdt.org/article.asp?issn=1319-2442;year=2022;volume=33;issue=7;spage=66;epage=76;aulast=Ibrahim
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AT hatemali hemodialysisaccesssurveillanceareviewoftheliterature
AT hafizraza hemodialysisaccesssurveillanceareviewoftheliterature
AT mahmoudmohamed hemodialysisaccesssurveillanceareviewoftheliterature