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Glucose infusion test: a new screening test for vascular access recirculation.
A Magnasco1, S Alloatti, G Bonfant
1Nephrology Dialysis Unit, Sestri Levante Hospital, Aosta Hospital, Occupational Medicine Unit, and S. Martino Hospital, Genoa, Italy.
Kidney International
|May 3, 2000
Summary
A new glucose infusion test (GIT) accurately screens for vascular access recirculation during dialysis. This simple, low-cost method is more sensitive than the urea test for detecting reduced dialysis efficiency.
Area of Science:
- Nephrology
- Vascular Access
- Dialysis
Background:
- Vascular access recirculation reduces dialysis efficiency.
- A novel screening test using glucose infusion is proposed.
Purpose of the Study:
- To introduce and validate the glucose infusion test (GIT) for detecting vascular access recirculation.
Main Methods:
- The GIT involves a basal blood sample, a glucose bolus, and a second sample to measure blood glucose changes.
- Recirculation is calculated using a regression equation based on glucose levels.
- The GIT was compared to the urea test in 39 hemodialysis patients.
Main Results:
- The GIT demonstrated a good correlation with the urea test (r=0.93).
- The GIT identified 7 patients with small recirculation missed by the urea test.
- Recirculation was present in 22 patients (mean 11.8%) and absent in 17 (mean 0.06%).
Conclusions:
- The glucose infusion test is more sensitive, simpler, and provides immediate results compared to the urea test.
- GIT is an accurate, low-cost method for screening and follow-up of vascular access in dialysis units.