Importance of monitoring and treatment of failed maturation in radiocephalic arteriovenous fistula in predialysis: Role of ultrasound.

Autor:	Muray Cases S; Servicio de Nefrología, Hospital General Universitario Reina Sofía, Murcia, España. Electronic address: Salomuray@gmail.com., García Medina J; Servicio de Radiología Vascular, Hospital General Universitario Reina Sofía, Murcia, España., Pérez Abad JM; Servicio de Cirugía, Clínica Mesa del Castillo, Murcia, España., Andreu Muñoz AJ; Servicio de Nefrología, Hospital General Universitario Reina Sofía, Murcia, España., Ramos Carrasco F; Servicio de Nefrología, Hospital General Universitario Reina Sofía, Murcia, España., Pérez Pérez A; Servicio de Nefrología, Hospital General Universitario Reina Sofía, Murcia, España., Lacasa Pérez N; Servicio de Radiología Vascular, Hospital General Universitario Reina Sofía, Murcia, España., Cabezuelo Romero JB; Servicio de Nefrología, Hospital General Universitario Reina Sofía, Murcia, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia [Nefrologia] 2016 Jul-Aug; Vol. 36 (4), pp. 410-7. Date of Electronic Publication: 2016 Mar 02.
DOI:	10.1016/j.nefro.2015.10.016
Abstrakt:	Unlabelled: The aim of the study was to analyse outcomes of AVF-RC in predialysis stage in which a clinical and radiological follow up of its maturation had been done and primary failure had been treated. Material and Methods: We studied 127 RC-AVF in 117 predialysis patients. All cases had a preoperative map. The RC-AVF was considered mature if it had a brachial artery flow ≥500ml/min and a cephalic vein diameter of ≥4mm. Primary failure was treated radiologically or surgically depending on the type of lesion. Fifty-eight patients started dialysis at the time of the study. Results: In 106 RC-AVF without thrombosis, 72 (68%) were mature and 34 (32%) were immature. A total of 97% of the immature had at least one lesion, and the most common site was the post-anastomotic vein. Lesions were found in 31% of mature RC-AVF, and 18% of patients required treatment. Radiological treatment was the most frequent for maturation failure. After 6 months, primary and secondary patency were 59% and 78%, while after 12 months they were 48% and 77%, respectively. The 80% of patients started dialysis with a distal AVF (76% RC-AVF and 4% ulnar basilic). None of the patients with treated immature RC-AVF started dialysis with CVC, while 78% of the patients started with said AVF. Conclusion: Ultrasonography for monitoring maturation provides advantages over clinical monitoring. With our management of RC-AVF in predialysis, 80% of patients start dialysis with an adequate distal AVF. (Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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