Arteriovenous (AV) access thrombosis remains one of the most troubling AV access related complications affecting hemodialysis patients. It necessitates an urgent and occasionally complicated thrombectomy procedure and increases the risk AV access loss. The routine use of AV access surveillance for early detection and management of stenosis to reduce thrombosis remains controversial.
Results from a multicenter, prospective, randomized clinical trial comparing standard of care with monthly Ultrasound Dilution Technique (UDT) flow surveillance using a Transonic flow measurement device concluded that monthly surveillance with Transonic’s HD03 and standard of care reduced per patient thrombotic events vs standard of care alone and without significantly increasing the total number of angiographic procedures.
The recently released 2019 Update of the KDOQI Clinical Practice Guideline for Vascular Access offers a different approach to vascular access care. The guidelines emphasize a more individualized patient-focused approach and recommend development of an End-Stage Renal Disease (ESRD) Life Plan that takes each patient’s specific needs and preferences into account when choosing an access for that patient. In addition, the guidelines call for proactive planning for likely complications and remediation of a current access configuration.
KDOQI Guideline 19.2 addresses the issue of excessive flow in the AVF/AVG that can lead to other complications. All hemodialysis patients should be regularly monitored for cardiac issues, and hemodialysis patients with active cardiovascular disease should be frequently assessed. During hemodialysis, the Transonic HD03 Hemodialysis Monitor can noninvasively measure cardiac output. It also can calculate an Access Flow to Cardiac Output ratio along with additional cardiac function parameters without the patient requiring additional testing.
Learn more about how Transonic HD03 supports ESRD Life Plans in this booklet, which provides five patient case examples.