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ID 49040
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Author
Ugawa, Toyomu
Sakurama, Kazufumi
Takaoka, Munenori
Fujiwara, Yasuhiro
Kabashima, Narutoshi
Azuma, Daisuke
Iida, Atsuyoshi
Tada, Keitaro
Sato, Nobuo
Kino, Koichi
Fukushima, Masaki
Abstract
The functioning of an arteriovenous fistula (AVF) used for vascular access during hemodialysis has been assessed mainly by dilution methods. Although these techniques indicate the immediate recirculation rate, the results obtained may not correlate with Kt/V. In contrast, the clearance gap (CL-Gap) method provides the total recirculation rate per dialysis session and correlates well with Kt/V. We assessed the correlation between Kt/V and CL-Gap as well as the change in radial artery (RA) blood flow speed in the fistula before percutaneous transluminal angioplasty (PTA) in 45 patients undergoing continuous hemodialysis. The dialysis dose during the determination of CL-Gap was 1.2 to 1.4 Kt/V. Patients with a 10% elevation or more than a 10% relative increase in CL-Gap underwent PTA (n=45), and the values obtained for Kt/V and CL-Gap before PTA were compared with those obtained immediately afterward. The mean RA blood flow speed improved significantly (from 52.9 to 97.5cm/sec) after PTA, as did Kt/V (1.07 to 1.30) and CL-Gap (14.1% to -0.2%). A significant correlation between these differences was apparent (r=-0.436 and p=0.003). These findings suggest that calculating CL-Gap may be useful for determining when PTA is required and for assessing the effectiveness of PTA, toward obtaining better dialysis.
Keywords
hemodialysis
recirculation
clearance gap
vascular access
percutaneous transluminal angioplasty
Amo Type
Original Article
Published Date
2012-12
Publication Title
Acta Medica Okayama
Volume
volume66
Issue
issue6
Publisher
Okayama University Medical School
Start Page
443
End Page
447
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
Copyright Holders
CopyrightⒸ 2012 by Okayama University Medical School
File Version
publisher
Refereed
True
PubMed ID
Web of Sience KeyUT