Document Detail

Obese and non-obese hemodialysis patients have a similar prevalence of functioning arteriovenous fistula using pre-operative vein mapping.
MedLine Citation:
PMID:  12356190     Owner:  NLM     Status:  MEDLINE    
AIMS: The arteriovenous fistula (AVF) is the preferred hemodialysis access. Subset analyses of both the HEMO and DOPPS studies have shown that obese hemodialysis patients have a lower prevalence of functioning AVF. Doppler ultrasound may increase the prevalence of functioning AVF in obese subjects. PATIENTS AND METHODS: The effect of pre-operative vein mapping employed between 10/01/98 and 12/08/00 on the prevalence of functioning AVF in a single university hemodialysis program was studied. Preoperative ultrasound was performed to study venous and arterial systems on both arms. RESULTS: There were 50 obese patients, defined as bodymass index (BMI) > or = 27 kg/m2, and 130 patients with a lower BMI. The groups were similar in mean age and diabetes prevalence. The obese group had statistically significantly more females 34/50 versus 61/130 with p = 0.01. There was no statistically significant difference between the vein mapping parameters studied in the two BMI groups, including mean mid-forearm cephalic vein diameter, distal radial artery peak systolic velocity and subclavian vein patency. No obese patient required venography. There was no significant difference between the number of functioning AVF in both groups (22/50 obese, 48/130 lower BMI, p = 0.24). CONCLUSIONS: Pre-operative vein mapping is associated with a similar prevalence of functioning AVF in obese and lower BMI patients. Pre-operative ultrasound screening is a useful tool to promote AVF placement in obese patients.
J A Vassalotti; A Falk; E D Cohl; J Uribarri; V Teodorescu
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  58     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-10-01     Completed Date:  2003-03-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  211-4     Citation Subset:  IM    
Division of Nephrology, Mount Sinai Medical Center, New York, NY 10029-6574, USA.
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MeSH Terms
Arteriovenous Shunt, Surgical*
Blood Flow Velocity
Body Mass Index
Forearm / blood supply
Graft Occlusion, Vascular / epidemiology
Middle Aged
Obesity / physiopathology*
Preoperative Care
Radial Artery / ultrasonography
Renal Dialysis*
Ultrasonography, Doppler

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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