Abstract: SA-PO0450
High Accuracy of Predictive Model for Fistula Maturation Using Early Ultrasonography
Session Information
- Dialysis: Vascular Access
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Zaidi, Syed Shaukat Abbas, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- Chan, Cindy, Fresenius Medical Care Hong Kong Ltd, Hong Kong, Hong Kong
- Saxena, Sugandha, Fresenius Medical Care India Pvt Ltd, New Delhi, DL, India
- Cheung, Yan Yi, Fresenius Medical Care Singapore Pte Ltd, Singapore, Singapore
- Wang, Xin, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Grobe, Nadja, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Kotanko, Peter, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Neri, Luca, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
- Mitra, Sandip, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- Nikam, Milind, Fresenius Medical Care Dubai, Dubai, United Arab Emirates
Background
Doppler ultrasound (DUS) is commonly used to assess maturation although at a much later stage. Our study aims to evaluate the role of early DUS-derived parameters for predicting fistula maturation.
Methods
Our study analyzed a sub-group of patients enrolled in the Manchester Vascular Access Study who underwent arteriovenous fistula (AVF) creation between 2011 to 2015 (n=170). Patients with a post-surgical DUS scan between days 11 and 20 were included (n=59). AVF maturation was defined as described in our previous reports. Logistic regression was used to analyze the associations between baseline clinical and DUS-derived parameters with AVF maturation, and to build a predictive model. The final model’s accuracy was evaluated using receiver operating characteristics curves and areas under the curves (AUC) estimates, with five-fold cross validation (CV) AUC to assess overfitting. All analyses were performed using R (v4.1.1).
Results
Patient and DUS-derived features are listed in Table 1. In univariate analysis, mean AVF flow ≥350 mL/min, venous diameter ≥4.25 mm, brachial artery flow ≥550 mL/min and maximal accessory vein diameter ≥2.4 mm were associated with AVF maturation (Figure 1A). Age, sex, diabetes, and vein depth were not associated with maturation. Predictive modelling yielded an AUC of 0.88, and a CV AUC of 0.79 (Figure 1B) suggesting strong discriminative ability and good generalizability with low likelihood of overfitting.
Conclusion
Some features of early DUS can help predict maturation outcomes. Coupled with clinical characteristics, we built a predictive model with high AUC. If validated in other cohorts, such models, perhaps in combination with other biomarkers, can aid early intervention and thereby improve outcomes.
Funding
- Commercial Support – Fresenius Medical Care