Would In-Time Screening Ultrasonography Diagnose Clinically Silent Dialysis AccessStenosis?

Overview

Background.
Stenoses are leading factors limiting dialysis vascular access patency. Both physical and haemodynamicexaminations are used in stenoses screening. To estimate potential advantage of ultrasonography as a screeningmeasure, we calculated both sensitivity and specificity of clinical (nephrological) diagnoses of access stenosescompared with ultrasound.Methods and Results. 268 examinations of 193 subjects were included into this comparison. Linear-array 7.5 MHzultrasound probe were used for whole-length access examination. Sensitivity of clinical examination was 35.8 %,specificity 92.8 %. Sensitivity did not differ significantly according to the stenosis localization.Conclusions. Ultrasound use in dialysis access screening would considerably increase the number of stenosesdiagnosed in-time. On the contrary, clinical suspicion on access stenosis is highly specific, therefore it is notindispensable to confirm it by ultrasound.

Key words:
haemodialysis, vascular access, ultrasonography.