Role of Venous Pressure Monitoring as Predictor of High Flow Access in Prevalent Hemodialysis Patients

Abstract

Background: Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines suggest that high intra access pressure may be regarded as a surrogate for arteriovenous fistula (AVF) outflow stenosis. It can be measured using static venous pressure (sVP) or standardized dynamic venous pressure (dVP). Access blood flow (Qa) measurement is also recommended by (K/DOQI) as the preferred method for access surveillance, but it is not readily available at all dialysis facilities. We hypothesized that in absence of clinical signs of stenosis, venous pressure(both dynamic &static) can be used as predictor of AVF Qa: a simple and useful screening technique that can be used to detect fistulae with inappropriately high Qa (>1500ml/min). High Qa fistulae may compromise cardiac function, and may require an endovascular or surgical intervention to guard against heart failure