Document Type : Original Article
Authors
1
Internal Medicine Department , Faculty of Medicine , Ain Shams University , Cairo , Egypt
2
Ministry of Health , Cairo , Egypt
10.12816/0033761
Abstract
Background: According to KDOQI guidelines, the lower limit of arteriovenous fistula blood flow accounting for 600 ml / min. We have observed that this limit was not enough, at least for our patients. The aim of this work was to prove the hypothesis that this limit must be higher for performing adequate dialysis.
Patiemts and methods : Fifty patients on prevalent hemodialysis were included in this study. They were divided into 3 groups; group I: 12 patients formed low flow group, group II: 18 patients formed moderate flow group , and group III: 20 patients formed high flow group . Complete physical examination including clinical fistula examination for patency , were performed for all patients . Laboratory tests performed for all patients included :urea reduction ratio (URR %) , serum calcium ,serum phosphorus , calcium – phosphorus product , serum albumin , hemoglobin , serum Iron , serum ferritin ,TIBC , Transferrin saturation (TSAT %) , Kt / V (number used to quantify hemodialysis treatment adequacy), serum creatinine , together with blood urea before and after session . Fistula blood flow and static venous pressure were determined by Doppler ultrasound . Fistulogram was performed to confirm the fistula stenosis site , whenever detected by Doppler .
Results: Mineral bone profile markers , Iron profile markers , together with malnutrition – inflammation complex indicators , were all in favour of moderate and high flow groups , mainly the moderate flow group II due to the presence of much less complications than the other groups . Conclusion: We have to try to perform arteriovenous fistulae for ESRD patients needing regular dialysis , in such a way that fistula blood flow is above 800 ml / min , and it is better to be within the range of 801 – 1600 ml / min .
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