Kidney Week

Abstract: FR-PO769

Environmental and Patient Specific Factors Associated with Absolute AVF Blood Flow

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

• King, David H., Mid Essex Hospitals, Chelmsford, Essex, United Kingdom

David H. King,

• Taylor, Michael Graeme, Kings College London, London, London, United Kingdom

Michael Graeme Taylor,

• Al-Qaisi, Mo, Mid Essex Hospitals, Chelmsford, United Kingdom

Mo Al-Qaisi,

• Abeygunasekara, Sumith C., Broomfield hospital, Chelmsford, United Kingdom

Sumith C. Abeygunasekara,

• Ali, Abdelgalil Abdelrahman, Broomfield Hospital, Chelmsford, United Kingdom

Abdelgalil Abdelrahman Ali,

Background

AVF blood pressure measurement using a novel monitoring device BluedopTM combined with Color Duplex blood flow measurement has been used to identify the incidence of Normal and Failing Arteriovenous Fistulae 1. The study protocol has been repeated in two widely different environments, Europe (UK) and Africa (Sudan).

Methods

A patented algorithm based on blood velocity waveform shape, was used to calculate mean distal brachial artery blood pressure P proximal to the a-v anastomosis. Dividing flow Q by pressure P yields venous conductance VC. A value of less than 10ml per minute per mmHg correlates with a significant venous outflow stenosis of 60% or greater.

Results

There were 54 dialysis patients in the Sudan cohort of which 9 were failing according to VC criteria leaving 45 normally functioning AVF .There were 68 dialysis patients in the UK cohort of which 10 were failing, leaving 58 normally functioning AVF in the study. There was no significant difference in the percentage of failing AVF in either group (Sudan = 17%, UK = 15%). Table 1 shows Mean ± 1SD for P, Q and VC in normally functioning AVF.
AVF blood flow in the Sudanese cohort was 69% greater than the UK cohort. This is a highly significant difference. The following dependencies were tested and shown to be minor or not significant NS. The tests shown here were on the Sudanese cohort: AVF Flow vs Age = NS (R2= 0.0019), AVF Flow vs Gender = NS ( female vs male = 1578 ± 567ml/min vs 1882 ± 910 ml/min ). In contrast published values for minimum seasonal ambient temperatures show Khartoum is approximately 14 deg C hotter than London throughout the year, supporting the concept of a temperature related association with AVF development.

Conclusion

Further research into the influence of a range of low, medium and high seasonal temperatures on AVF blood flow may supply insight into early AVF failure as well as early maturation.

¹ Volume blood flow, static pressure ratio and venous conductance in native arterio-venous fistulae: three surveillance methods compared: J Vasc Access 2015;16(3);211-217

Table 1