Kidney Week

Abstract: TH-PO0945

Access Flow Monitor Module-Based Surveillance of Vascular Access in Hemodialysis: Is It Ready for Prime Time?

Session Information

• Vascular Access: Research and Cases
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 803 Dialysis: Vascular Access

Authors

• Selvi, Antonio, Ospedale Assisi, Assisi, Umbria, Italy

Antonio Selvi, MD

• Ricciardi, Daniela, Ospedale Assisi, Assisi, Umbria, Italy

Daniela Ricciardi, DM

• Carriero, Ilaria, Ospedale Assisi, Assisi, Umbria, Italy

Ilaria Carriero, MD

Background

Active surveillance of vascular access (VA) in dialysis patients may enable early identification and correction of potential dysfunctions of the arteriovenous fistula (AVF). Clinical surveillance was enhanced by integrating AVF blood flow (Qa) measurements using the Access Flow Monitor (AFM) module embedded in the 6008 dialysis machine (Fresenius Medical Care), with the aim of defining an active surveillance protocol

Methods

The active VA surveillance protocol was implemented over 15 months in 85 ESRD patients with AVF (Fig1). Qa was measured during dialysis using the ionic dialysance–based AFM method, integrated in 6008 dialysis machine, according to protocol. Measurements were collected at baseline (T0) and after 5 (T5), 10 (T10), and 15 months (T15). Patients were stratified into Qa categories (Thrombosis Risk, Low, Normal and High Flow). Transitions between Qa categories were recorded at each measurement timepoint. At baseline, in a subgroup of 49 patients, AFM-derived Qa measurements were compared with Doppler US measurements

Results

Bland–Altman analysis on comparison between AFM and Doppler subgroup is shown by Fig2. By the end of the study, a total of 20 AVF revisions were performed in patients at risk of thrombosis (TR) or with Qa reduction leading to a lower flow category. 8 patients did not complete the study due to AVF closure

Conclusion

The implemented active surveillance protocol enabled early prediction, identification, and correction of AVF dysfunctions. The AFM module proved to be an integral part of the protocol, providing accurate and reproducible Q_a measurements and demonstrating ease of use in routine clinical practice