Clinical value of ultrasound in evaluating complications after autologous arteriovenous fistula and predicting its maturity in patients with chronic renal failure
Objective To evaluate the incidence of complications 1 d after autologous arteriovenous fistula(AVF)in patients with chronic renal failure,and to explore its clinical application value in predicting AVF maturation.Methods A total of 147 patients with chronic renal failure who needed autologous arteriovenous fistuloplasty in our hospital were selected.Ultrasound examination on the 1st day after AVF were performed to obtained cephalic vein diameter(CVD),radial artery diameter(RAD),brachial artery blood flow volume(FV).The complications of AVF were evaluated,and patients were divided into normal AVF structure group and complications group,AVF maturation evaluation was performed 6 weeks after surgery.The differences of general data and ultrasound parameters were compared between the normal AVF structure group and the complications group,as well as between mature AVF and immature AVF patients in the normal AVF structure group.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of ultrasound parameters in predicting AVF maturation 1 d after AVF.Results Totally 147 patients were divided into the normal AVF structure group(n=116)and the complications group(n=31).The CVD,brachial artery FV were significant different statistically between the two groups(both P<0.001).There were no statistically significant differences in age,gender ratio,primary diseases,surgical site,surgical methods and RAD between the two groups.Patients with normal AVF structure were divided into mature AVF(n=95)and immature AVF(n=21)according to AVF maturation 6 weeks after surgery.There were statistically significant differences in the primary disease and brachial artery FV between the two groups(both P<0.05).There were no significant differences in age,sex ratio,surgical site,surgical method,CVD and RAD.ROC curve analysis showed that the area under the curve of brachial artery FV for predicting AVF maturation 1 d after AVF was 0.899(95%confidence interval:0.840～0.958,P<0.001),and the sensitivity and specificity were 0.863 and 0.857,respectively.Conclusion Ultrasound examination on the 1st day after AVF in patients with chronic renal failure helps in the early diagnosis of AVF complications,and brachial artery FV has certain clinical value in predicting AVF maturation.
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