MEASUREMENT OF BLOOD-FLOW THROUGH AV-FISTULAS BY MEANS OF DOPPLER SONOGRAPHY IN REGULARLY HEMODIALYZED PATIENTS

In regularly dialyzed patients a variety of pathological events can negatively influence haemodynamics and blood flow through arterio-venous fistula, leading to inadequate blood flow through the dialyzer or disturbances in hemodynamics of the whole body. It therefore appears important to quantify flow velocity and volume flow through the arteriovenous fistula in such cases. We used a Vasoview computer controlled system for noninvasive vascular diagnostics based on B-scan "real-time" ultrasound for imaging the structure of tissue, combined with pulsed Doppler ultrasound for determination of hemodynamics. Thirty patients (16 males and 14 females, aged 45 +/- 10 years; range 23 to 61 years), with different periods spent on hemodialysis (5.5 +/- 3.1 years, range 1 to 11 years) were included in this study. The average systolic, diastolic and mean blood volume flows were 2131.8 +/- 565.8, 972.0 +/- 309.6 and 728.4 +/- 287.4 ml/min, respectively. The mean blood volume flow was calculated by integration of the area under curve of blood flow in one heart cycle on the Doppler signal. It is calculated by the apparatus and displayed on the screen during measurement. The average blood vessel diameter was 9.1 +/- 1.3 mm (mu +/- sigma). The results revealed a marked inter-individual variation in volume flow through arteriovenous fistulae of dialyzed uremics (range 240.0 to 1200.0 ml/min). Doppler ultrasound thus appears to be a valuable method for determination of blood flow through arteriovenous fistula of dialyzed uremics as well as for detection of hemodynamics disturbances of interest, such as turbulent blood flow.