Kidney Week

Abstract: FR-PO731

The Repeatability of AVF Mean Blood Flow in Temperate and Sub Saharan Environments

Session Information

• Dialysis: Vascular Access - I
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• King, David H., Broomfield Hospital, Chelmsford, United Kingdom

David H. King,

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

Abdelgalil Abdelrahman Ali,

• Al-Qaisi, Mo, Imperial College London, London, United Kingdom

Mo Al-Qaisi,

Background

We have previously demonstrated a 70% difference between Dialysis AVF blood flow in the UK and Sudan, the Sudan mean being greater than the UK mean ⁽¹⁾. The study has recently been extended to 4 renal centres in Sudan.. A recent 7 centre study in the USA has published the mean AVF blood flow at 6 weeks maturation ^(2),. We have characterised UK and USA environments as temperate and the Sudan environment as sub Saharan.

Methods

AVF blood flow was measured with a Duplex device in all centres. Clinical indications were used in the USA study to eliminate failing or failed AVF from the study of mature fistulae. . The incidence of failing AVF in each cohort in the UK and Sudan was studied using a new device Bluedop ™ ⁽¹⁾

Results

The results are tabulated below. Additional data was recorded including patient Age, Gender and AVF location.

Conclusion

Conclusion: A number of explanations for the elevated Sub Saharan mean Blood Flow results have been explored. Mean annual temperature appears to be a possible cause, Published values for minimal seasonal ambient temperatures show Khartoum is approximately 14 degrees C warmer than London thoughout the year.USA ambient temperatures have not been studied. Deep Infra Red studies have been shown to speed AVF maturation. It should also be noted that although AVF failure rates were comparable in Sudan and the UK, that active intervention was not available in Sudan.
^{(1) Environmental and Patient Specific Factors associated with AVF Blood Flow. ASN Abstracts New Orleans, November 3rd 2017
(2) Relationship Between Clinical Processes and Arteriovenous Fistula Cannulation and Maturation: A MultiCenter Cohort Study, AJKD , published online, doi: 10.1053/j.akjd.2017.10.027}

Results Table

Funding

• Commercial Support – Bluedop Medical Ltd