| Accuracy of physical examination and intra-access pressure in the detection of stenosis in hemodialysis arteriovenous fistula. | |
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MedLine Citation:
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PMID: 18248519 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Both physical examination (PE) and intra-access pressure (IAP) measurements have been used in the identification of stenosis in an arteriovenous access. The aim of this study was to evaluate the accuracy of PE and IAP in the diagnosis of arteriovenous fistula (AVF) stenosis. A total of 84 patients were enrolled in the study (54% men, mean age of 50.7 +/- 12.7 years and mean AVF patency of 24.9 +/- 7.8 months, 52% radiocephalic). Abnormalities of pulse and thrill were used as the diagnostic tools for the detection of stenosis using the physical examination. For IAP, stenosis was suspected when the ratio between IAP at the arterial puncture site and the mean blood pressure was <0.13 or >0.43. The diagnosis of stenosis was confirmed by Doppler ultrasound (DU). Sensitivity (S), specificity (SP), positive predictive value (PPV), negative predictive value (PNV), and accuracy were calculated for the two early detection tests. According to DU, 50 (59%) AVF were considered positive for the presence of stenosis. Fifty-six (66%) AVF were considered positive for the presence of stenosis by PE and 34 (40%) by IAP. S, SP, PPV, and NPV for PE and IAP were 96%, 76%, 86%, and 93% and 60%, 88%, 88%, and 60%, respectively. The accuracy for PE and IAP was 88% and 71%, respectively. PE proved to be an accurate method for the diagnosis of stenosis and should be part of all surveillance protocols of stenosis detection in AVF. |
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Authors:
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Rodrigo Peixoto Campos; Domingos Candiota Chula; Sonia Perreto; Miguel Carlos Riella; Marcelo Mazza do Nascimento |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2008-02-01 |
Journal Detail:
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Title: Seminars in dialysis Volume: 21 ISSN: 0894-0959 ISO Abbreviation: Semin Dial Publication Date: 2008 May-Jun |
Date Detail:
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Created Date: 2008-06-06 Completed Date: 2008-10-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8911629 Medline TA: Semin Dial Country: United States |
Other Details:
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Languages: eng Pagination: 269-73 Citation Subset: IM |
Affiliation:
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Division of Interventional and Critical Care Nephrology, Hospital Universitário Evangélico de Curitiba, Curitiba, Brazil. rodrigopcampos@uol.com.br |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Arteriovenous Shunt, Surgical / adverse effects* Blood Pressure Determination Confidence Intervals Constriction, Pathologic / diagnosis Female Humans Kidney Failure, Chronic / therapy Male Middle Aged Physical Examination* Predictive Value of Tests Renal Dialysis Reproducibility of Results |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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