The Role of Color Doppler Ultrasonography in Evaluation of Arteriovenous Fistulae in Haemodialysis

Abstract

Chronic renal failure is considered as worldwide health problem, with increasing incidence and prevalence, high costs and poor outcomes. Before the emergence of renal replacement therapy renal failure was considered a synonym of death. Renal replacement therapy made it possible to be treated; either by renal transplantation, hemodialysis and peritoneal dialysis. Maintaining permanent hemodialysis vascular access is an overwhelming problem that has been traditionally considered the major obstacle in dialysis patients. The aim of this study is to evaluate the role and usefulness of Doppler sonography in planning hemodialysis native AVF via assessment of the suitability of the arteries and veins of the upper limb and prediction of hemodialysis native fistula success before surgery and assessment of maturation and possible dysfunction and complications of already formed native hemodialysis arterio-venous fistula. Preoperative Doppler ultrasound provides a road map for the future design of created hemodialysis AVF with prediction of its outcome and alteration of surgical decision. Postoperative Doppler ultrasound describes the fistula related complications e.g. stenosis, thrombosis, infection, aneurysms and pseudoaneurysm, venous hypertension and fistula dysfunction and so, it can prolong access longevity and decrease the cost of haemodialysis access management. In order to minimize morbidity and cost, an effort should be directed at the goal that all patients starting haemodialysis treatment have a vascular access ready to be punctured.