Five Years of Vascular Access Stenosis Surveillance by Blood Flow Rate Measurements during Hemodialysis Using the Delta-H Method

Purpose To report experience over five years of vascular access (VA) stenosis surveillance. Methods We prospectively monitored the blood flow rate (QA) of 145 VA in 131 ESRD (age 62.6 ±13.5 y) patients (pts). QA measurement: within the first hour of the hemodialysis (HD) session by the Delta-H method using the Crit Line III Monitor. All VA with baseline QA < 700 mL/min or decreased > 20% from baseline over time met the positive evaluation (PE) criteria and were referred for angiography (AG) plus elective intervention if stenosis ≥ 50%. Results We found 54 cases of PE in 47 VA; the AG was performed in 87% (47/54) cases of PE and most of them (43/47, positive predictive value: 91.5%) showed significant stenosis (mean degree 80.5 ±12.9%). Mean QA increased from 554.7±107.6 mL/min to 977.9 ± 359.9 mL/min just before versus after preventive intervention (P