Korean J Anesthesiol.  2016 Aug;69(4):375-381. 10.4097/kjae.2016.69.4.375.

Preoperative ultrasonographic findings of internal jugular veins and carotid arteries in kidney transplant recipients

• Choi JW
• Kim GS
• Lee SW
• Park JB
• Lee JJ
• Ko JS

• KMID: 2344604
• DOI: http://doi.org/10.4097/kjae.2016.69.4.375

Abstract

BACKGROUND
Hemodialysis via the internal jugular vein (IJV) has been widely used for patients with end stage renal disease (ESRD) patients, as they have a higher risk of arterial diseases. We investigated the ultrasonographic findings of the IJV and carotid artery (CA) in recipients of kidney transplantation (KT) and identified factors influencing IJV/CA abnormalities.
METHODS
We enrolled 120 adult KT recipients. Patients in group A (n = 57) had a history of IJV hemodialysis, while those in group B (n = 63) were not yet on dialysis or undergoing dialysis methods not involving the IJV. The day before surgery, we evaluated the state of the IJV and CA using ultrasonography. We followed patients with IJV stenosis for six months after KT.
RESULTS
Ultrasonography revealed that four patients (7%) in group A had IJV abnormalities, while no patients in group B had abnormalities (P = 0.118). Of the four patients with abnormalities, one with 57.4% stenosis normalized during follow- up. However, another patient with 90.1% stenosis progressed to occlusion, while the two patients with total occlusion remained the same. Twenty patients in group A (n = 11) and B (n = 9) had several CA abnormalities (P = 0.462). Upon multivariate analysis with stepwise selection, height and age were significantly correlated with IJV stenosis (P = 0.043, odds ratio = 0.9) and CA abnormality (P = 0.012, odds ratio = 1.1), respectively.
CONCLUSIONS
IJV abnormalities (especially with a history of IJV hemodialysis) and CA abnormalities may be present in ESRD patients. Therefore, we recommend ultrasonographic evaluation before catheterization.

Keyword

Central venous catheterization; Kidney transplantation; Safety; Ultrasonography

MeSH Terms

Adult
Carotid Arteries*
Catheterization
Catheterization, Central Venous
Catheters
Constriction, Pathologic
Dialysis
Humans
Jugular Veins*
Kidney Failure, Chronic
Kidney Transplantation
Kidney*
Multivariate Analysis
Odds Ratio
Renal Dialysis
Transplant Recipients*
Ultrasonography