American Journal of Kidney Diseases
Volume 52, Issue 5 , Pages 930-938 , November 2008

Risk of Hemodialysis Graft Thrombosis: Analysis of Monthly Flow Surveillance

  • Sunanda J. Ram, PhD

      Affiliations

    • Division of Nephrology and Hypertension, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA
    • ,
  • Raja Nassar, PhD

      Affiliations

    • Mathematics and Statistics, College of Engineering and Science, Louisiana Tech University, Ruston, LA
    • ,
  • Jack Work, MD

      Affiliations

    • Renal Division, Emory University School of Medicine, Atlanta
    • ,
  • Kenneth Abreo, MD

      Affiliations

    • Division of Nephrology and Hypertension, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA
    • ,
  • Neville R. Dossabhoy, MD

      Affiliations

    • Division of Nephrology and Hypertension, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA
    • ,
  • William D. Paulson, MD

      Affiliations

    • Charlie Norwood VA Medical Center, Medical College of Georgia, Augusta, GA
    • Section of Nephrology, Hypertension, and Renal Transplantation, Medical College of Georgia, Augusta, GA
    • Corresponding Author InformationAddress correspondence to William D. Paulson, MD, Charlie Norwood VAMC, Mail Rt 254, 1 Freedom Way, Augusta, GA 30904

Received 10 October 2007 ,Accepted 22 July 2008.

References 

  1. Hakim R, Himmelfarb J. Hemodialysis access failure: A call to action. Kidney Int. 1998;54:1029–1040
  2. Allon M. Do we really need periodic monitoring of vascular access for hemodialysis?. Nephsap. 2007;6:111–116
  3. Tonelli M, James M, Wiebe N, Jindal K, Hemmelgarn B. Ultrasound monitoring to detect access stenosis in hemodialysis patients: A systematic review. Am J Kidney Dis. 2008;51:630–640
  4. Ram SJ, Nassar R, Sharaf R, Magnasco A, Jones SA, Paulson WD. Thresholds for significant decrease in hemodialysis access blood flow. Semin Dial. 2005;18:558–564
  5. DeSoto DJ, Ram SJ, Faiyaz R, Birk CG, Paulson WD. Hemodynamic reproducibility during blood flow measurements of hemodialysis synthetic grafts. Am J Kidney Dis. 2001;37:790–796
  6. Atray NK, Ram SJ, Work J, Eason JM, Oder TF, Paulson WD. A longitudinal study of hemodialysis graft stenosis: Role of progressive stenosis in thrombosis. J Am Soc Nephrol. 2001;12:281A;(abstr)
  7. White JJ, Jones SA, Ram SJ, Schwab SJ, Paulson WD. Influence of luminal diameters on flow surveillance of hemodialysis grafts: Insights from a mathematical model. Clin J Am Soc Nephrol. 2006;1:972–978
  8. Bay WH, Henry ML, Lazarus JM, Lew NL, Ling J, Lowrie EG. Predicting hemodialysis access failure with color flow Doppler ultrasound. Am J Nephrol. 1998;18:296–304
  9. Bosman PJ, Boereboom FT, Eikelboom BC, et al. Graft flow as a predictor of thrombosis in hemodialysis grafts. Kidney Int. 1998;54:1726–1730
  10. Neyra NR, Ikizler TA, May RE, et al. Change in access blood flow over time predicts vascular access thrombosis. Kidney Int. 1998;54:1714–1719
  11. Singh N, Ahmad S, Wienckowski JR, Murray BM. Comparison of access blood flow and venous pressure measurements as predictors of arteriovenous graft thrombosis. J Vasc Access. 2006;7:66–73
  12. McDougal G, Agarwal R. Clinical performance characteristics of hemodialysis graft monitoring. Kidney Int. 2001;60:762–766
  13. Paulson WD, Ram SJ, Birk CG, Work J. Does blood flow accurately predict thrombosis or failure of hemodialysis synthetic grafts? (A meta-analysis). Am J Kidney Dis. 1999;34:478–485
  14. Paulson WD, Ram SJ, Birk CG, Zapczynski M, Martin SR, Work J. Accuracy of decrease in blood flow in predicting hemodialysis graft thrombosis. Am J Kidney Dis. 2000;35:1089–1095
  15. White JJ, Bander SJ, Schwab SJ, et al. Is percutaneous transluminal angioplasty an effective intervention for A-V graft stenosis?. Semin Dial. 2005;18:190–202
  16. Paulson WD. Access monitoring does not really improve outcomes. Blood Purif. 2005;23:50–56
  17. Sands JJ. Vascular access monitoring improves outcomes. Blood Purif. 2005;23:45–49
  18. Besarab A. Access monitoring is worthwhile and valuable. Blood Purif. 2006;24:77–89
  19. National Kidney Foundation. KDOQI Clinical Practice Guidelines for Vascular Access: Update 2006. Am J Kidney Dis. 2006;48(suppl 1):S176–S322
  20. Arbabzadeh M, Mepani B, Murray BM. Why do grafts clot despite access blood flow surveillance?. Cardiovasc Intervent Radiol. 2002;25:501–505
  21. May RE, Himmelfarb J, Yenicesu M, et al. Predictive measures of vascular access thrombosis: A prospective study. Kidney Int. 1997;52:1656–1662
  22. Ram SJ, Work J, Eason JM, Caldito GC, Pervez A, Paulson WD. A prospective randomized controlled trial of blood flow and stenosis surveillance of hemodialysis grafts. Kidney Int. 2003;64:272–280
  23. Krivitski NM. Theory and validation of access flow measurement by dilution technique during hemodialysis. Kidney Int. 1995;48:244–250
  24. Kleinbaum DG, Klein M. Logistic Regression: A Self Learning Text. In: (ed 2). New York, NY: Springer; 2002;p. 327–375
  25. Moist LM, Churchill DN, House AA, et al. Regular monitoring of access flow compared with monitoring of venous pressure fails to improve access survival. J Am Soc Nephrol. 2003;14:2645–2653
  26. Dember LM, Holmberg EF, Kaufman JS. Randomized controlled trial of prophylactic repair of hemodialysis arteriovenous graft stenosis. Kidney Int. 2004;66:390–398
  27. Robbin ML, Oser RF, Lee JY, Heudebert GR, Mennemeyer ST, Allon M. Randomized comparison of ultrasound surveillance and clinical monitoring on arteriovenous graft outcomes. Kidney Int. 2006;69:730–735
  28. Paulson WD, Ram SJ, Faiyaz R, Caldito GC, Atray NK. Association between blood pressure, ultrafiltration, and hemodialysis graft thrombosis: A multivariable logistic regression analysis. Am J Kidney Dis. 2002;40:769–776
  29. Chang CJ, Ko PJ, Hsu LA, et al. Highly increased cell proliferation activity in restenotic hemodialysis vascular access after percutaneous transluminal angioplasty: Implication in prevention of stenosis. Am J Kidney Dis. 2004;43:74–84

 Originally published online as doi:10.1053/j.ajkd.2008.07.028 on October 9, 2008.

PII: S0272-6386(08)01229-8

doi: 10.1053/j.ajkd.2008.07.028

American Journal of Kidney Diseases
Volume 52, Issue 5 , Pages 930-938 , November 2008

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