scholarly journals P1367THE RELATIONSHIP OF SERUM PHOSPHORUS LEVEL AND ARTERIOVENOUS FISTULA DYSFUNCTION IN MAINTENANCE HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hyung-Jong Kim ◽  
Mi Jung Lee
Keyword(s):  
Blood Flow ◽  
Risk Factor ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Vascular Access ◽  
Univariate Analysis ◽  
Blood Flow Rate ◽  
Dialysis Unit ◽  
The Mean ◽  
The Impact

Abstract Background and Aims It is known that maintenance of function of arteriovenous fistula (AVF) is very important in the management of hemodialysis (HD) patients. Therefore, identifying a risk factor for decreased vascular access flow has a clinical relevance in real world practice. Although hyperphosphatemia plays a crucial role in the pathogenesis of vascular calcification, there is lack of studies evaluating the effect of hyperphosphatemia on AVF. This study investigated the impact of serum phosphorous (P) on vascular access flow in HD patients. Method Sixty-two maintenance HD patients who visited dialysis unit of Bundang CHA Medical Center from November 2016 to December 2017 were included in this study. Serum P levels were determined every month and time-averaged serum P was calculated. All patients had left arm AVF (side to side anastomosis) and vascular access flow was assessed by Transonic HD 03. Decreased vascular access flow was defined as less than 600 mL/min. Results The mean age was 57.9 ± 12.1 years, 32 patients (51.6%) were men. The mean serum P levels were 5.1 ± 1.1 mg/dL and the vascular access flow was 1,071.4 ± 504.2 mL/min. Decreased vascular access flow was observed in 14 of 62 patients (22.6%). In univariate analysis, higher serum P was significantly associated with decreased vascular access flow (odds ratio [OR]=2.089, 95% confidence interval [CI]=1.159-3.766, P=0.014). But there was no significant association of dialysis blood flow rate, ejection fraction on echocardiography and serum calcium (Ca) levels with vascular access flow. Multivariable analysis indicated that higher serum P was independently associated with greater risk of decreased vascular access flow (OR=4.012, 95% CI=1.651-9.711, P=0.002). Old age, reduced EF, low dialysis blood flow rate and higher serum Ca was not associated with vascular access flow. Conclusion This study demonstrated that higher serum P was the independent risk factor for decreased vascular access flow in maintenance HD patients. Serial monitoring of serum P may be helpful to stratify the risk of vascular access dysfunction in these patients.

scholarly journals The Relationship between Serum Phosphorous Level and Arteriovenous Fistula Dysfunction in Maintenance Hemodialysis Patients

2020 ◽  
Vol 95 (1) ◽  
pp. 36-42
Author(s):  
Yu Bum Choi ◽  
Jung Hyun Kim ◽  
Mi Jung Lee ◽  
Seungyoon Choi ◽  
Hyung Jong Kim
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Medical Center ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Blood Flow Rate ◽  
Maintenance Hemodialysis ◽  
Dialysis Unit ◽  
Reduced Ejection Fraction ◽  
The Impact

Background/Aims: Maintaining vascular access (VA) is very important in the management of hemodialysis (HD) patients. Therefore, the identification of risk factors for decreased vascular access flow has clinical relevance. The aim of the present study was to investigate the impact of serum phosphorus (P) on autologous arteriovenous fistula flow in HD patients.Methods: Sixty-two maintenance HD patients who visited the dialysis unit of CHA Bundang Medical Center between November 2016 and December 2017 were included in the study. Serum P levels were obtained every month, and time-averaged serum P was calculated. All patients had left arm arteriovenous fistulas (AVF; side-to-side anastomosis). AVF flow was assessed by Transonic HD 03. Decreased AVF flow was defined as < 600 mL/min.Results: Decreased AVF flow was observed in 14 of 62 patients. In univariate analysis and multivariable analysis, higher serum P had a significant independent association with decreased AVF flow. Advanced age, reduced ejection fraction, low blood flow rate in dialysis, and higher serum calcium were not associated with AVF flow.Conclusions: The present study demonstrated that higher serum P was an independent risk factor for decreased autologous AVF flow in maintenance HD patients. Serial monitoring of serum P may be helpful in stratifying patients by risk of AVF dysfunction, and proper management of serum P levels may be helpful in maintaining flow through autologous AVFs.

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.

Optimizing dialysis dose by increasing blood flow rate in patients with reduced vascular-access flow rate

2001 ◽  
Vol 38 (5) ◽  
pp. 948-955 ◽  
Author(s):  
Daxenos R.M. Hassell ◽  
Frank M. van der Sande ◽  
Jeroen P. Kooman ◽  
Jan P. Tordoir ◽  
Karel M.L. Leunissen
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Vascular Access ◽  
Blood Flow Rate ◽  
Dialysis Dose

Five Years of Vascular Access Stenosis Surveillance by Blood Flow Rate Measurements during Hemodialysis Using the Delta-H Method

2012 ◽  
Vol 13 (3) ◽  
pp. 321-328 ◽  
Author(s):  
Ramón Roca-Tey ◽  
Rosa Samon ◽  
Omar Ibrik ◽  
Empar Roda ◽  
Juan Carlos González-Oliva ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Vascular Access ◽  
Blood Flow Rate ◽  
Vascular Access Stenosis

Hemodynamic impact of VASQ device in vascular access creation

2020 ◽  
pp. 112972982098315
Author(s):  
Roberto Palumbo ◽  
Sara Dominijanni ◽  
Alessia Centi ◽  
Gabriele D’Urso ◽  
Paola Tatangelo ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Complication Rate ◽  
Neointimal Hyperplasia ◽  
Arterial Flow ◽  
Control Group ◽  
Secondary Patency ◽  
Arteriovenous Fistulae ◽  
The Mean ◽  
The Impact

Background: Native arteriovenous fistula is the preferred vascular access in term of functionality, efficiency and complication rate. Nevertheless, research continues to seek strategies to reduce the risk of neointimal hyperplasia and hemodynamic modification. The aim of the study was to evaluate the impact on hemodynamic of the VasQ device in arteriovenous fistulae creation. Methods: The analysis included patients who underwent to fistula creation with or without implantation of the VasQ device between May and September 2019. The hemodynamic parameters were evaluated pre-operatively and at a follow-up of 1, 3, 6 months. The patency and complication rate were evaluated. Results: Fifteen VasQ devices were implanted during 30 arteriovenous fistula surgery. The baseline patients features were similar between groups (VasQ treated/control). At baseline, preoperative arterial flow was similar; radial artery diameter at surgical site was 3.4 ± 0.8 mm in treated and 2.8 ± 0.5 mm in the control group. The mean arterial flow at 1 month was 480 ± 210 mL/min in treated and 561 ± 27 mL/min in the control group. At 3 months the mean arterial flow in treated was 645 ± 143 mL/min versus 824 ± 211 mL/min ( p = 0.02) in the control group; at 6 months the arterial flow was 714 ± 146 mL/min versus 810 ± 194 mL/min ( p = 0.05) in control group. The cardiac output flow at 6 months in the treated group was 4458 ± 928 mL/min versus 5599 ± 1355 mL/min ( p = 0.05) in the control group. At 6 months the primary patency was 73% and 80% and the secondary patency 80% and 86% in treated compared to the control group, respectively. No VASQ device complications were recorded. Conclusion: The analysis of these data suggested that using VasQ device could be protective against the hemodynamic modification that occur during arteriovenous fistulae creation.

Numerical Simulation of the Stent Expansion Process based on the Hemodynamic Characteristics of Bidirectional Fluid-structure Coupling

2020 ◽  
Author(s):  
Siyu Bai ◽  
Hong Li ◽  
Li Li
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Vascular Wall ◽  
Maximum Pressure ◽  
Expansion Process ◽  
Fluid Structure ◽  
Stent Expansion ◽  
Stent System ◽  
The Impact

Abstract Hitherto, research on the fluid-structure coupling of coronary stents has mostly considered the state after stent expansion following implantation. However, the factors and how they affect stent expansion are as yet, unclear. To further investigate stent expansion, this paper proposes a model combining balloon, stent, and blood using Solidworks. Thereafter, a co-simulation using ANSYS Workbench is implemented using the methods of finite element and finite volume, to analyze bidirectional fluid-structure coupling during the expansion of a balloon-expandable stent, for periodically varying blood loads. By comparing the blood flow rate in the vessel, pressure on the endovascular wall, and the pressure and stress on the stent system at different points in time, it can be seen that the higher the blood flow rate, the greater the pressure on the endovascular wall and stent system. Furthermore, the larger the volume of the implant, the greater the maximum blood flow rate and maximum pressure on the endovascular wall, and the more drastic the change along the axis. In summary, the results of the present study indicate that the stent expansion process has a significant effect on the blood flow rate and pressure on the vascular wall; however, the impact of blood load on stent stress can be ignored.

Recirculation Reassessed: The Impact of Blood Flow Rate and the Low-Flow Method Reevaluated

1994 ◽  
Vol 23 (6) ◽  
pp. 846-848 ◽  
Author(s):  
Richard A. Sherman ◽  
James J. Matera ◽  
Laura Novik ◽  
Ronald P. Cody
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Low Flow ◽  
Flow Method ◽  
The Impact

scholarly journals Vascular access blood flow for hemodialysis: A risk factor for development of cardiovascular complications in hemodialysis patients

2007 ◽  
Vol 60 (3-4) ◽  
pp. 183-186 ◽  
Author(s):  
Dejan Petrovic ◽  
Biljana Stojimirovic
Keyword(s):  
Blood Flow ◽  
Risk Factor ◽  
Vascular Access ◽  
Ventricular Remodeling ◽  
Average Length ◽  
Left Ventricular Remodeling ◽  
Blood Flow Rate ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Flow Through

Introduction. Vascular access blood flow rate of 100-350 cm/s and between 500 and 1000 ml/min, points to normal vascular access function and adequate hemodialysis. High blood flow through the arteriovenus fistula overloads the left ventricle inducing left ventricular remodeling. Material and methods. The aim of the study was to establish the degree of correlation between blood flow through the vascular access for hemodialysis and echocardiographic parameters for the assessment of left ventricular hypertrophy and left ventricular dilatation and left ventricular function. The research included 115 patients (M:F 71:44), average age 53.30?12.17 years, average length of dialysis 4.51 ? 4.01 years and average Kt/Vsp index 1.17?0.23. Results. The average blood flow through the vascular access for hemodialysis was 662.27?301.59 ml/min, EDDLV 54.52?6.42 mm, and EDVi 100.80?34.62 ml/m2. There is a statistically significant positive correlation between blood flow through vascular access for hemodialysis and EDDLV and EDVi. Conclusion. High blood flow through the vascular access for hemodialysis is an independent risk factor for the development of cardiovascular complications in patients on hemodialysis. .

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