Prediction of vascular access stenosis: Blood temperature monitoring with the Twister versus static intra-access pressure ratio.
BACKGROUND:The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend intra-access flow (Qa) measurement as the preferred vascular access surveillance method over static intra-access pressure ratio (SIAPR). Recently, it has become possible to perform Qa measurement during hemodialys...
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doaj-1d304e8570cd4ec29ea64d39c50671192020-11-24T21:08:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011310e020463010.1371/journal.pone.0204630Prediction of vascular access stenosis: Blood temperature monitoring with the Twister versus static intra-access pressure ratio.Yoo Jin ChoiYoung-Ki LeeHayne Cho ParkEun Yi KimAjin ChoChaehoon HanSun Ryoung ChoiHanmyun KimEun-Jung KimJong-Woo YoonJung-Woo NohBACKGROUND:The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend intra-access flow (Qa) measurement as the preferred vascular access surveillance method over static intra-access pressure ratio (SIAPR). Recently, it has become possible to perform Qa measurement during hemodialysis using thermodilution method called blood temperature monitoring (BTM) with the Twister device. The aim of this study was to investigate the correlation between Qa by BTM and SIAPR and to compare the performance of two tests in prediction of vascular access stenosis. METHODS:The study was performed from January 2016 to November 2017 and included 97 patients with arteriovenous fistulas (AVF). Qa by BTM and SIAPR were simultaneously measured every 1~3 months with a total of 449 measurements during study period. RESULTS:In our study population, mean age was 59.9±10.0 years and 61.9% were diabetes. The mean Qa obtained by BTM was 1186±588 mL/min. There was no correlation between Qa by BTM and venous SIAPR (r = 0.061, P = 0.196). Angiography identified 36 stenotic AVFs (37.1%) among the study subjects. They included 13 cases with only inflow stenosis, 6 with only outflow stenosis, and 17 with stenosis on both sides. Receiver-operating characteristic (ROC) curve analysis showed that Qa by BTM had higher discriminative ability to diagnose vascular access stenosis compared to SIAPR (P <0.001). The Qa less than 583 mL/min showed the highest diagnostic accuracy in vascular stenosis prediction. CONCLUSION:Intradialytic measurement of Qa by BTM showed better diagnostic power over venous SIAPR in prediction of vascular access stenosis.http://europepmc.org/articles/PMC6205593?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yoo Jin Choi Young-Ki Lee Hayne Cho Park Eun Yi Kim Ajin Cho Chaehoon Han Sun Ryoung Choi Hanmyun Kim Eun-Jung Kim Jong-Woo Yoon Jung-Woo Noh |
spellingShingle |
Yoo Jin Choi Young-Ki Lee Hayne Cho Park Eun Yi Kim Ajin Cho Chaehoon Han Sun Ryoung Choi Hanmyun Kim Eun-Jung Kim Jong-Woo Yoon Jung-Woo Noh Prediction of vascular access stenosis: Blood temperature monitoring with the Twister versus static intra-access pressure ratio. PLoS ONE |
author_facet |
Yoo Jin Choi Young-Ki Lee Hayne Cho Park Eun Yi Kim Ajin Cho Chaehoon Han Sun Ryoung Choi Hanmyun Kim Eun-Jung Kim Jong-Woo Yoon Jung-Woo Noh |
author_sort |
Yoo Jin Choi |
title |
Prediction of vascular access stenosis: Blood temperature monitoring with the Twister versus static intra-access pressure ratio. |
title_short |
Prediction of vascular access stenosis: Blood temperature monitoring with the Twister versus static intra-access pressure ratio. |
title_full |
Prediction of vascular access stenosis: Blood temperature monitoring with the Twister versus static intra-access pressure ratio. |
title_fullStr |
Prediction of vascular access stenosis: Blood temperature monitoring with the Twister versus static intra-access pressure ratio. |
title_full_unstemmed |
Prediction of vascular access stenosis: Blood temperature monitoring with the Twister versus static intra-access pressure ratio. |
title_sort |
prediction of vascular access stenosis: blood temperature monitoring with the twister versus static intra-access pressure ratio. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2018-01-01 |
description |
BACKGROUND:The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend intra-access flow (Qa) measurement as the preferred vascular access surveillance method over static intra-access pressure ratio (SIAPR). Recently, it has become possible to perform Qa measurement during hemodialysis using thermodilution method called blood temperature monitoring (BTM) with the Twister device. The aim of this study was to investigate the correlation between Qa by BTM and SIAPR and to compare the performance of two tests in prediction of vascular access stenosis. METHODS:The study was performed from January 2016 to November 2017 and included 97 patients with arteriovenous fistulas (AVF). Qa by BTM and SIAPR were simultaneously measured every 1~3 months with a total of 449 measurements during study period. RESULTS:In our study population, mean age was 59.9±10.0 years and 61.9% were diabetes. The mean Qa obtained by BTM was 1186±588 mL/min. There was no correlation between Qa by BTM and venous SIAPR (r = 0.061, P = 0.196). Angiography identified 36 stenotic AVFs (37.1%) among the study subjects. They included 13 cases with only inflow stenosis, 6 with only outflow stenosis, and 17 with stenosis on both sides. Receiver-operating characteristic (ROC) curve analysis showed that Qa by BTM had higher discriminative ability to diagnose vascular access stenosis compared to SIAPR (P <0.001). The Qa less than 583 mL/min showed the highest diagnostic accuracy in vascular stenosis prediction. CONCLUSION:Intradialytic measurement of Qa by BTM showed better diagnostic power over venous SIAPR in prediction of vascular access stenosis. |
url |
http://europepmc.org/articles/PMC6205593?pdf=render |
work_keys_str_mv |
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