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Is ionic dialysance useful for early detection of vascular access dysfunction? Six illustrative cases
Néstor Fontseré1, Miquel Blasco1, Marta Arias1
1Department of NephrologyDepartment of Interventional RadiologyDepartment of Vascular Surgery, Vascular Access Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain.
Abstract:
Continuous ionic dialysance monitoring is a useful clinical tool to determine the dialysis dose in real time in each hemodialysis session. We followed up 49 patients for 16 months. Six patients with a Kt reduction of ≥20% in >3 consecutive hemodialysis sessions were identified. Fistulography demonstrated significant stenosis in all 6 patients. Angioplasty was performed in 5 with an excellent angiographic result and optimal Kt levels were restored. Unexplained and persistent Kt reduction in patients with stable chronic kidney disease under hemodialysis could represent, together with an accurate vascular access examination, a practical and additional indirect method for the early detection of vascular access dysfunction.
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