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Updated: Mar 19, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Preoperative vessel mapping in chronic kidney disease patients - a center experience
Patrícia Barreto1,2, Paulo Almeida3,4,5, Norton de Matos3,4,5
1Nephrology Department, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia - Portugal.
Insights
Preoperative vascular mapping using duplex ultrasound is crucial for successful arteriovenous access in hemodialysis patients. This patient-centered approach improves outcomes and increases arteriovenous fistula creation rates.
Area of Science:
- Nephrology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Hemodialysis (HD) is the primary treatment for stage 5 chronic kidney disease.
- Vascular access planning is critical for effective HD treatment.
- Duplex ultrasound (DU) is essential for preoperative vascular mapping.
Purpose of the Study:
- To evaluate the effectiveness of preoperative vascular mapping in planning arteriovenous (AV) access for hemodialysis.
- To assess primary failure, patency, and survival rates of AV accesses.
Main Methods:
- Retrospective descriptive nonrandomized study of 108 end-stage kidney disease patients.
- Inclusion of patients referred from eight HD centers for AV access creation (AV fistula or AV graft).
- Assessment of primary failure, primary unassisted patency (PP), primary assisted patency (PAP), and cumulative survival at 6 and 12 months.
Main Results:
- 86 AV accesses created: 79 (91.9%) AV fistulas (AVFs) and 7 (8.1%) AV grafts (AVGs).
- AVF group: 15% primary failure; 6-month PP 63.8%, 12-month PP 48.3%; 6 & 12-month PAP 80.7%; 6 & 12-month cumulative survival 80.7%.
- AVG group: 0% primary failure; 6 & 12-month PP 66.7%; 6 & 12-month PAP and cumulative survival 100%.
Conclusions:
- Preoperative vascular mapping with a patient-centered approach is critical for successful AV access.
- This approach can lead to improved outcomes and increased AVF creation rates.
- Duplex ultrasound plays a vital role in preoperative vascular assessment for hemodialysis access.
Purpose:
Hemodialysis (HD) is the main treatment modality in stage 5 chronic kidney disease, and vascular access planning is a crucial step in the path to dialysis treatment. Beyond detailed patient history and physical examination, duplex ultrasound (DU) evaluation is essential in preoperative vascular mapping.
Methods:
A retrospective descriptive nonrandomized study was performed and included 108 end-stage kidney disease patients referred from eight HD centers to be assessed for creation of an arteriovenous (AV) access (AV fistula or AV graft). We assessed primary failure, primary unassisted patency (PP) and primary assisted patency (PAP) rates and cumulative survival of AV accesses at 6 and 12 months.
Results:
We created 86 AV accesses of which 79 (91.9%) were AV fistulas (AVFs) (29 distal AVFs, 49 proximal AVFs and 1 femorofemoral AVF) and 7 (8.1%) arteriovenous grafts (AVGs). Fifteen percent (15%) (n = 12) of primary failure occurred in the AVF group. Any case of primary failure was observed between AVGs.In the AVF group, PP at 6 months was 63.8 % and at 12 months was 48.3%, PAP was 80.7% at 6 and 12 months. PP excluding primary failures was 73.0% and 55.3% at 6 and 12 months, respectively. The cumulative survival at 6 and 12 months was 80.7%.In the AVG group, PP at 6 months and 12 months was 66.7%, PAP and cumulative survival at 6 and 12 months were of 100%.
Conclusions:
This study demonstrates that preoperative vascular mapping with a patient-centered approach may be critical to achieve good outcomes allowing the increase in AVF access.
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