Document Detail


Evaluating the need for and effect of percutaneous transluminal angioplasty on arteriovenous fistulas by using total recirculation rate per dialysis session ("clearance gap").
MedLine Citation:
PMID:  23254578     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The functioning of an arteriovenous fistula (AVF) used for vascular access during hemodialysis has been assessed mainly by dilution methods. Although these techniques indicate the immediate recirculation rate, the results obtained may not correlate with Kt/V. In contrast, the clearance gap (CL-Gap) method provides the total recirculation rate per dialysis session and correlates well with Kt/V. We assessed the correlation between Kt/V and CL-Gap as well as the change in radial artery (RA) blood flow speed in the fistula before percutaneous transluminal angioplasty (PTA) in 45 patients undergoing continuous hemodialysis. The dialysis dose during the determination of CL-Gap was 1.2 to 1.4 Kt/V. Patients with a 10% elevation or more than a 10% relative increase in CL-Gap underwent PTA (n=45), and the values obtained for Kt/V and CL-Gap before PTA were compared with those obtained immediately afterward. The mean RA blood flow speed improved significantly (from 52.9 to 97.5cm/sec) after PTA, as did Kt/V (1.07 to 1.30) and CL-Gap (14.1% to -0.2%). A significant correlation between these differences was apparent (r=-0.436 and p=0.003). These findings suggest that calculating CL-Gap may be useful for determining when PTA is required and for assessing the effectiveness of PTA, toward obtaining better dialysis.
Authors:
Toyomu Ugawa; Kazufumi Sakurama; Takashi Yorifuji; Munenori Takaoka; Yasuhiro Fujiwara; Narutoshi Kabashima; Daisuke Azuma; Takahiro Hirayama; Kohei Tsukahara; Sunao Morisada; Atsuyoshi Iida; Keitaro Tada; Naoki Shiba; Nobuo Sato; Shingo Ichiba; Koichi Kino; Masaki Fukushima; Yoshihito Ujike
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta medica Okayama     Volume:  66     ISSN:  0386-300X     ISO Abbreviation:  Acta Med. Okayama     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417611     Medline TA:  Acta Med Okayama     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  443-7     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.ugawat@md.okayama-u.ac.jp.
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