[Would ultrasonography contribute to the early detection of clinically silent dialysis access stenoses?]

Stenoses are leading factors limiting dialysis vascular access patency. Both physical and haemodynamic examinations are used in stenoses screening. To estimate potential advantage of ultrasonography as a screening measure, we calculated both sensitivity and specificity of clinical (nephrological) diagnoses of access stenoses compared with ultrasound.

268 examinations of 193 subjects were included into this comparison. Linear-array 7.5 MHz ultrasound probe were used for whole-length access examination. Sensitivity of clinical examination was 35.8%, specificity 92.8%. Sensitivity did not differ significantly according to the stenosis localization.

Ultrasound use in dialysis access screening would considerably increase the number of stenoses diagnosed in-time. On the contrary, clinical suspicion on access stenosis is highly specific, therefore it is not indispensable to confirm it by ultrasound.