The relationship between arteriovenous fistula blood flow rate and pulmonary artery pressure in hemodialysis patients

2007 ◽  
Vol 40 (2) ◽  
pp. 509-513 ◽  
Author(s):  
Gursel Acarturk ◽  
Ramazan Albayrak ◽  
Mehmet Melek ◽  
Seref Yuksel ◽  
Ihsan Uslan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Arteriovenous Fistula ◽  
Pulmonary Artery Pressure ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Hemodialysis Patients ◽  
Artery Pressure ◽  
The Relationship

Effects of the Arteriovenous Fistula on Pulmonary Artery Pressure and Cardiac Output in Patients with Chronic Renal Failure

2009 ◽  
Vol 10 (3) ◽  
pp. 160-166 ◽  
Author(s):  
Ali Akbar Beigi ◽  
Amir Mir Mohammad Sadeghi ◽  
Ali Reza Khosravi ◽  
Mehdi Karami ◽  
Hassan Masoudpour
Keyword(s):  
Renal Failure ◽  
Cardiac Output ◽  
Chronic Renal Failure ◽  
Pulmonary Artery ◽  
Arteriovenous Fistula ◽  
Pulmonary Artery Pressure ◽  
Vascular System ◽  
Diabetic Patients ◽  
Artery Pressure ◽  
The Relationship

Introduction Access to the vascular system is necessary in patients with chronic renal failure planned to undergo dialysis. One of the complications of end-stage renal disease patients is pulmonary hypertension (PHT). Temporary arterio-venous access closure and successful kidney transplantation causes a significant fall in cardiac output and pulmonary artery pressure (PAP), indicating the possibility that excessive pulmonary blood flow is involved in the pathogenesis of the disease. We attempted to study the relationship of PHT with arteriovenous fistula (AVF) creation, as well as to assess the relationship between AVF flow and fistula characteristics. Methods Fifty patients were included in the study. Echocardiography was used to evaluate systolic PAP, cardiac output (CO), and ejection fraction (EF) before creating the AVF. After a follow-up interval of at least 6 months, a second echocardiographic assessment and a Doppler sonographic assessment of their fistula flow were carried out. Complete data were available for 34 patients. Results Study data were collected from 34 patients, 28 males and 6 females with a mean age of 52 yrs ranging from 15–78 yrs. The data showed a statistically significant positive correlation between fistula flow and PAP2 and PAP changes (p<0.05). Mean fistula flow was 1322 ml/min in patients without PHt and 2750 ml/min in patients with PHT. this difference (1428 ml/ min) was statistically significant (p=0.03). We found a significant negative correlation between PAP1 and EF1 and PAP2 and EF2 (p<0.05). In addition, the mean EF2 in patients without PHT was 57% in contrast to 46% in patients with PHT. Mean fistula flow in radial fistulae (mean=422 ml/min, range: 370–474 ml/min) was significantly less than brachial fistulae (mean=1463 ml, range: 270–3300 ml/min) (p=0.03). Mean systolic PAP2 of 14.8 mmHg in transplanted patients was 5.9 mmHg less than those who were not transplanted (20.7 mmHg). Diabetes was the most common cause of renal failure and diabetics had a significant reduction in their EF (15.5%) compared with non-diabetic patients (1% reduction) (p=0.016). Conclusion Fistula flow, PAP and EF of all patients should be checked at least 6 months after fistula creation. Patients with higher fistula flow rates and patients with diabetes mellitus need to be more closely observed. In addition, elderly patients with significant cardiac and other comorbidities may be more prone to develop symptoms after AVF creation

scholarly journals Application of Non-thermal Commscope Irradiation in Preventing Com- plications of Hemodialysis Fistula

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Leng Hui
Keyword(s):  
Blood Flow ◽  
Blood Vessel ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Hemodialysis Patients ◽  
First Choice ◽  
Long Time ◽  
And Control

Abstract: Objective: To ensure that the patient’s treatment and control of the patient’s blood in the course of long-term dialysis, in order to ensure the blood flow rate at the rate of hemodialysis in the blood vessel of hemodialysis patients, mortality rate. Methods: In many Western countries, it has been found from the experience of long-term accumulation, arteriovenous fistula (AVF) is the first choice for long-term dialysis blood patients, which has a lot of a little bit, not only from the infection rate and blood flow, which has a lot of advantages.But its existence is also a lot of complications, non-thermal Commscope irradiation is a very effective way. Results: The method was compared with the method, and it was found that P <0.05, which was statistically significant. Conclusion: AVF is the preferred method of vascular access in patients with persistent dialysis, which is very easy to be punctured and has a very long time for maintenance. It is very important to carry out the treatment, treatment and surveillance of AVF complications and the use of means.

scholarly journals The Relationship between the Blood Flow Volume of the Arteriovenous Fistula and its Early Effect on the Pulmonary Artery Pressure and the Left Ventricular Dimensions and Functions

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Lotfy ◽  
E M Elfiky ◽  
A N Ali ◽  
O A Diab
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Arteriovenous Fistula ◽  
Pulmonary Artery Pressure ◽  
Left Ventricular ◽  
P Value ◽  
Flow Volume ◽  
Blood Flow Volume ◽  
A Value ◽  
The Relationship

Abstract Background Cardiovascular complications are leading cause of the death in hemodialysis patients. One of these complications is pulmonary hypertension which complicates chronic renal failure in 12–45% of cases and causes an increase in all-cause mortality of 2-3 folds in the dialysis population. Another complication is left ventricular hypertrophy which is a strong predictor of morbidity and mortality in patients with ESRD. Arteriovenous fistulas increase cardiac output and lead to significant increases in both the mass and the diameter of the left ventricular wall in the long-term duration. There is evidence that A-V fistula creation is a major risk factor for developing a new onset Congestive Heart Failure Aim of the Work Our study aimed to assess the relationship between blood flow volume of arteriovenous fistula (AVF) and its effect on the Pulmonary Artery Pressure (PAP) and the Left Ventricular (LV) dimensions and functions and to find out the cut off value of the AVF blood flow volume above which the cardiac dimensions and functions start to get affected. Methods and Results The study included 50 individuals selected from Internal Medicine and Nephrology outpatient clinics and inpatient wards at Ain Shams University Hospitals during the period from November 2016 until October 2018 who underwent full echocardiography studies once at the beginning of the study and once after 3 months and also underwent Duplex sonography on arteriovenous fistula to measure blood flow rate. The results showed that after 3 months the only significant changes were the ejection fraction (P-value of 0.029), the fractional shortening (P-value of 0.009), and the E/A ratio (p-value of 0.005). Also, the results showed a correlation between AVF blood flow volume and LV internal dimensions. Left ventricular end-diastolic diameter (LVEDD) and Left ventricular end-systolic diameter (LVESD) increased significantly in patients with AVF blood flow volume of 1010 ml/min or above and 1120 ml/min or above respectively. Surprisingly, PASP showed no statistically significant change in our study. Conclusion Our study concluded that high flow AVF affect cardiac dimensions and functions. We proved that a cut off value of AVF blood flow volume affecting LV dimensions and functions can be reached and in our study, a value of 1010 ml/min or above affected the LVEDD and a value of 1120 ml/min or above affected the LVESD. Surprisingly, in our study, the PASP did not show a positive correlation with AVF blood flow volume.

scholarly journals Progressive dysfunction of nitric oxide synthase in a lamb model of chronically increased pulmonary blood flow: a role for oxidative stress

2008 ◽  
Vol 295 (5) ◽  
pp. L756-L766 ◽  
Author(s):  
Peter E. Oishi ◽  
Dean A. Wiseman ◽  
Shruti Sharma ◽  
Sanjiv Kumar ◽  
Yali Hou ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Nitric Oxide ◽  
Blood Flow ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Lung Tissue ◽  
Pulmonary Blood Flow ◽  
Artery Pressure ◽  
Oxide Synthase ◽  
Inhaled No

Cardiac defects associated with increased pulmonary blood flow result in pulmonary vascular dysfunction that may relate to a decrease in bioavailable nitric oxide (NO). An 8-mm graft (shunt) was placed between the aorta and pulmonary artery in 30 late gestation fetal lambs; 27 fetal lambs underwent a sham procedure. Hemodynamic responses to ACh (1 μg/kg) and inhaled NO (40 ppm) were assessed at 2, 4, and 8 wk of age. Lung tissue nitric oxide synthase (NOS) activity, endothelial NOS (eNOS), neuronal NOS (nNOS), inducible NOS (iNOS), and heat shock protein 90 (HSP90), lung tissue and plasma nitrate and nitrite (NOx), and lung tissue superoxide anion and nitrated eNOS levels were determined. In shunted lambs, ACh decreased pulmonary artery pressure at 2 wk ( P < 0.05) but not at 4 and 8 wk. Inhaled NO decreased pulmonary artery pressure at each age ( P < 0.05). In control lambs, ACh and inhaled NO decreased pulmonary artery pressure at each age ( P < 0.05). Total NOS activity did not change from 2 to 8 wk in control lambs but increased in shunted lambs (ANOVA, P < 0.05). Conversely, NOxlevels relative to NOS activity were lower in shunted lambs than controls at 4 and 8 wk ( P < 0.05). eNOS protein levels were greater in shunted lambs than controls at 4 wk of age ( P < 0.05). Superoxide levels increased from 2 to 8 wk in control and shunted lambs (ANOVA, P < 0.05) and were greater in shunted lambs than controls at all ages ( P < 0.05). Nitrated eNOS levels were greater in shunted lambs than controls at each age ( P < 0.05). We conclude that increased pulmonary blood flow results in progressive impairment of basal and agonist-induced NOS function, in part secondary to oxidative stress that decreases bioavailable NO.

Physiological alterations in increased pulmonary blood flow with and without pulmonary hypertension

1961 ◽  
Vol 16 (2) ◽  
pp. 305-308 ◽  
Author(s):  
Lois T. Ellison ◽  
David P. Hall ◽  
Thomas Yeh ◽  
H. Mobarhan ◽  
Joseph Rossi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Pulmonary Function ◽  
Pulmonary Artery Pressure ◽  
Pulmonary Blood Flow ◽  
Pulmonary Artery Hypertension ◽  
Systolic Pulmonary Artery Pressure ◽  
Venous Admixture ◽  
Artery Pressure ◽  
Physiological Alterations

Alterations in pulmonary function and in hemodynamics were studied in dogs with high pulmonary blood flow resulting from systemic pulmonary artery shunts. In order to facilitate elevation in pulmonary artery pressure, the vascular bed was reduced in some cases by obstructing branches of the pulmonary artery with Teflon clips or by lobectomy. Results in 30 control dogs and in 30 animals that survived 5–36 months (average 16) following creation of shunts indicated that pulmonary function was not significantly altered by increased pulmonary blood flow until pulmonary artery hypertension developed. When systolic pulmonary artery pressure exceeded 40 mm Hg, there was a decrease in arterial Po2, an increase in venous admixture percentage of cardiac output, and an increase in the A-a O2 difference during three levels of O2 breathing, indicating both abnormal venous admixture and abnormal diffusion. Possible explanations for these findings are presented. Evidence in one dog suggests that these alterations are reversible. Submitted on August 10, 1960

Blood Flow Rate and Access Recirculation in Hemodialysis

1992 ◽  
Vol 15 (8) ◽  
pp. 470-474 ◽  
Author(s):  
I.D. Daniels ◽  
G.M. Berlyne ◽  
R.H. Barth
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Hemodialysis Patients ◽  
Blood Pump ◽  
Concomitant Increase ◽  
Urea Clearance ◽  
Extracorporeal Blood

We studied the effect of extracorporeal blood flow rate (BFR) on access recirculation (recirc) in 19 hemodialysis patients. BUN was determined in simultaneous peripheral (P), arterial (A), and venous (V) blood obtained at BFRs of 200, 400 and 600 ml/min. Percent recirc was calculated for each BFR using the formula (P-A) / (P-V) X 100. Venous drip-chamber (VP) and pre-blood-pump (AP) pressures were measured at each BFR. Fistulograms were performed in 10 patients, and stenoses were identified in 5, all at the proximal (arterial) end of the access. Recirc increased with increasing BFR from 200 to 400 ml/min but increased little from 400 to 600 ml/min. At all BFRs recirc in the stenotic patients was higher than that of non-stenotic or unstudied patients. Urea clearance, corrected for recirc, rose with blood flow both in stenotic and non-stenotic patients. There were no differences in AP or in VP between stenotic and non-stenotic patients. At BFR ≥ 400 ml/min, a recirc threshold of 15% identified stenoses with sensitivity 100% and specificity 71%. We conclude (1) recirc increases with increasing BFR but not enough to outweight the concomitant increase in urea clearance; (2) significant access stenosis and recirc may be present even with low VP; (3) recirc was associated with arterial side stenoses; (4) at BFR ≥ 400 ml/min, access stenosis is associated with recirc > 15%.

scholarly journals Pulmonary calcification in hemodialysis patients: Correlation with pulmonary artery pressure values

2004 ◽  
Vol 66 (2) ◽  
pp. 806-810 ◽  
Author(s):  
Mordechai Yigla ◽  
Zohar Keidar ◽  
Isra Safadi ◽  
Naveh Tov ◽  
Shimon A. Reisner ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Hemodialysis Patients ◽  
Artery Pressure ◽  
Pulmonary Calcification

scholarly journals Evaluation of hemodynamic impact of absorbable sutures in native arteriovenous fistulas: A retrospective study

2019 ◽  
Vol 43 (1) ◽  
pp. 58-61
Author(s):  
Savino Occhionorelli ◽  
Fabio Fabbian ◽  
Yuri Battaglia ◽  
Tommaso Miccoli ◽  
Dario Andreotti ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Neointimal Hyperplasia ◽  
Blood Flow Rate ◽  
Absorbable Suture ◽  
Absorbable Sutures ◽  
The Mean ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation

One of the major causes of arteriovenous fistula failure is the venous stenosis due to aggressive neointimal hyperplasia. The aim of the study was to assess the arteriovenous fistula maturation comparing absorbable sutures and non-absorbable ones in native vessels. Surgeries performed during a period of 24 months by a single team of expert surgeons were evaluated. Surgeries that met the inclusion criteria, namely, age ⩾ 18 years and radio-cephalic arteriovenous fistula, were considered. According to type of suture, patients were classified as Max group (absorbable suture) and Prol group (non-absorbable). Data pertaining to 70 patients were collected; 51% were men and the mean age was 73 ± 12 years. In Max group, an increasing blood flow was observed during the first 4 weeks without post-operative complications. In Prol group, six patients had thrombosis that resulted in vascular access failure. After the first week, the duplex Doppler ultrasound of both groups showed a regular arteriovenous fistula maturation, with an increase of blood flow rate. Although pre-operative post-tourniquet mean vein diameters of Max group were not adequate, the mean vein diameter and mean blood flow rate increased after 4 weeks, respectively. On the contrary, in Prol group, mean vein diameters and blood flow rate decreased. The maturation of arteriovenous fistula and its functional performance were not altered by the type of suture (absorbable/non-absorbable). Absorbable sutures were associated with good results considering arteriovenous fistula maturation.

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