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Subject Area

Dermatology

Article Type

Original Study

Abstract

Objective To evaluate role of duplex Doppler ultrasound in assessing arteriovenous graft (AVG) function, detecting complications and analyzing the resistance index (RI) and flow in the afferent artery. Background End-stage renal disease causes serious health problems all over the world. The numbers of patients requiring dialysis have grown. In Egypt, it is the cause of 1.3% of all deaths, with much more incidence in later years of life. A well-functioning dialysis access is the lifeline for those patients. Patients and methods This study included 20 patients (male/female: 11/9) with end-stage renal disease and on regular hemodialysis using AVG. The prospective analyses of vascular access-related data included examination of graft morphology, shunt complications, and measurement of RI and volume of blood flow at the afferent artery. Results The most common complication seen was thrombosis (53.8%). Significant relation was found between graft function and flow volume of afferent artery (P < 0.001), with mean 1011.0 ± 135.9 ml/min in functional grafts and mean 220.8 ± 202 ml/min in dysfunctional grafts. There was a highly significant relation between graft function and afferent artery RI (P < 0.005), as 57.1% of functional grafts had their RI less than 0.5, with mean of 0.45 ± 0.05; 28.6% of complicated graft had their RI more than 0.5, with mean of 0.44 ± 0.12; and all dysfunctional graft had RI more than 0.5, with mean of 0.66 ± 0.09. Conclusion Duplex sonography has high accuracy in diagnosing and assessing most hemodialysis AVG-related complications while providing us with anatomic and hemodynamic information.

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