Prediction of stenosis in vascular access for hemodialysis using arterial and venous intra-access pressure (IAP) and its correlation with vascular ultrasonography: prospective study

• Grant number: 13/26688-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2014
• End date: August 31, 2015
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Marcone Lima Sobreira
• Grantee: Yago Henrique Padovan Chio
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Chronic renal failure (CRF) is a slow and irreversible installation metabolic disorder and it's very prevalent. It is estimated that there are about 1.2 to 1.5 million patients in Brazil. Clinical conditions such as: Diabetes Mellitus (DM), systemic arterial hypertension (SAH), Lupus, pyelonephritis, injuries are the leading causes of CRF. For hemodialysis, catheters are used or it's made an arteriovenous fistula (AVF), which can present complications such as thrombosis, venous hypertension, or shunt infections, which can contribute to loss of the access. For the analysis of the condition of the AVF , it is required knowledge of the venous and arterial intra - access pressure ( IAP ), which can be correlated with hemodynamic parameters such as venous pressure ( PV ) and blood flow ( QB ) provided during the hemodialysis by the own machine. In this prospective study, we measured the IAPs of the patients of the hemodialysis center in the HC-FMB/UNESP who have AVF in order to identify signals of subclinical stenosis, correlating them with ultrasound parameters ( systolic peak velocity/speed , end-diastolic velocity and flow volume ). The method is based on the isolation of the system and dialyzer pressures in order to measure the static pressure and collect the PV and QB value. These data will be placed in Excel spreadsheet for statistical analysis and correlation of these parameters with ultrasound data. Early diagnosis of subclinical stenosis can prevent access failure which can bring serious clinical complications to the patient.