Abstract: FR-PO775
A Meta-Analysis of Randomized Clinical Trials of Blood Flow and Stenosis Surveillance of Hemodialysis Access
Session Information
- Hemodialysis: Vascular Access - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 603 Hemodialysis: Vascular Access
Authors
- Hwang, Seon Deok, Inha University College of Medicine, Incheon, Korea (the Republic of)
- Lee, Seoung Woo, Inha University Hospital, Inchon City, Korea (the Republic of)
- Kim, Moon-Jae, Kidney Center, Inha University Hospital, Incheon City, Incheon, Korea (the Republic of)
Background
Regular vascular access blood flow (Qa) surveillance is recommended to detect graft or fistular stenosis. However, published studies have reported conflicting results of its utility that led healthcare professionals to doubt the benefits of this surveillance method. We find to access blood flow monitoring lowers the risk of AV access thrombosis or stenosis and that the outcomes differs between arteriovenous(AV) fistular (AVF) and arteriovenous graft (AVG)
Methods
We performed a systematic review of the available literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. An electronic search was conducted using the MEDLINE, EMBASE, and Cochrane Library databases from 1980 to 2017 for 9 RCTs involving dialysis access blood flow measurement. All studies combined included a total of 981 patients with hemodialysis vascular access of whom 649 had AVF and 332 had AVG.
Results
The estimated overall pooled risk ratio (RR) of thrombosis was 0.782 (95% confidence interval [CI], 0.553 to 1.107) favoring access blood flow monitoring. The pooled RR of thrombosis were 1.104 (95% CI, 0.672 to 1.816) in the AVG group. However, In AVF subgroup, the pooled RR of thrombosis statistically significant decrease surveillance group 0.562 (95% CI, 0.346 to 0.915) .
Conclusion
The benefit of AV access surveillance using access blood flow monitoring to lower the risk of thrombosis is uncertain in AVG group. But, using access AVF surveillance is effective method in hemodialysis patients.