Arterio-Venous Fistula Recirculation in Hemodialysis: Causes and Prevalences

[摘要] Introduction:ThemeasurementofArterio-Venous(A-V)FistulaRecirculationhasimportantdiagnosticimplicationsbecausetheefficiencyofhaemodialysis(HD)maybelimited,resultingindialysisdeliverybeinglessthanthatprescribed.ThepurposeofthestudyistodetermineitsprevalenceandcausesinourHDpatients.MaterialsandMethods:Werandomlyselected100endstagerenaldiseasepatientswithAVfistulathattheywereonHDmorethan3months.ThedegreeofrecirculationwasalsomeasuredwithUreabasedtwoneedletechniquemethod.Foreachpatientdistancesbetweenarterialandvenousanddistancesofneedlesfromfistulaanditsdirectionswasrecorded.EchocardiographyandA-VfistulaColorDopplerUltrasoundwerealsoperformed.Results:Bloodflowrateanddialysateflowratewere300mL/minand500mL/minrespectively.TheprevalenceofA-Vfistularecirculationwas17%(17patients).Averagedegreeofrecirculationbetweenthesepatientswas9.56±2.32%.Themostcommoncausewasmisplacementandormisdirectionofneedles(17patients).ThesecondcausewasheartfailurewithEjectionFraction>40%(8patients).Nodifferencewasseenbetweendiabeticversusnondiabetic(P=0.28)andhypertensiveversusnormotensive(P=0.21%)HDpatients.Conclusions:A-VfistularecirculationiscommonoccurrenceinHDpatientsandthemostcommoncauseofrecirculationismisplacementandormisdirectionofneedlessoweshouldhavemoreemphasisoneducationandtrainingofHDstaffs.

[学科分类] 基础医学

[关键词] A-V Fistula;Recirculation;Haemodialysis;End Stage Renal Disease