J Korean Med Sci.  2016 Aug;31(8):1239-1245. 10.3346/jkms.2016.31.8.1239.

The Impact of Hemodialysis and Arteriovenous Access Flow on Extracranial Hemodynamic Changes in End-Stage Renal Disease Patients

• Chung S
• Jeong HS
• Choi DE
• Song HJ
• Lim YG
• Ham JY
• Na KR
• Lee KW

• KMID: 2373751
• DOI: http://doi.org/10.3346/jkms.2016.31.8.1239

Abstract

In this study, we characterized cerebral blood flow changes by assessment of blood flow parameters in neck arteries using carotid duplex ultrasonography and predictive factors for these hemodynamic changes. Hemodynamic variables were measured before and during hemodialysis in 81 patients with an arteriovenous access in their arm. Hemodialysis produced significant lowering in peak systolic velocity and flow volume of neck arteries and calculated total cerebral blood flow (1,221.9 ± 344.9 [before hemodialysis] vs. 1,085.8 ± 319.2 [during hemodialysis], P < 0.001). Effects were greater in vessels on the same side as the arteriovenous access and these changes were influenced by arteriovenous access flow during hemodialysis, both in the CCA (r = -0.277, P = 0.015) and the VA (r = -0.239, P = 0.034). The change of total cerebral blood flow during hemodialysis was independently related with age, presence of diabetes, and systemic blood pressure.

Keyword

Arteriovenous Access; Carotid Duplex Ultrasonography; Cerebral Blood Flow; Hemodialysis

MeSH Terms

Aged
Carotid Arteries/diagnostic imaging
Cerebrovascular Circulation/*physiology
Dizziness/etiology
Female
Hemodynamics/*physiology
Humans
Kidney Failure, Chronic/*physiopathology
Male
Middle Aged
Renal Dialysis
Risk Factors
Ultrasonography, Doppler, Duplex

Figure

• 

  Fig. 1 Correlation between flow volume (FV) on the arteriovenous (AV) access side and the access flow during hemodialysis. (A) The change in combined FV in the common carotid arteries (CCAs) and vertebral arteries (VAs) on AV access side tends to increase as the amount of AV access flow increases (r = -0.277, r 2 = 0.077; P = 0.015). (B) The change in FV in the VAs on the AV access side also tended to increase as the amount of AV access flow increased (r = -0.239, r 2 = 0.057; P = 0.034).

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