[Would ultrasonography contribute to the early detection of clinically silent dialysis access stenoses?].

BACKGROUND

Stenoses are leading factors limiting dialysis vascular access patency. Both physical and haemodynamic examinations are used in stenoses screening. To estimate potential advantage of ultrasonography as a screening measure, we calculated both sensitivity and specificity of clinical (nephrological) diagnoses of access stenoses compared with ultrasound.

METHODS AND RESULTS

268 examinations of 193 subjects were included into this comparison. Linear-array 7.5 MHz ultrasound probe were used for whole-length access examination. Sensitivity of clinical examination was 35.8%, specificity 92.8%. Sensitivity did not differ significantly according to the stenosis localization.

CONCLUSIONS

Ultrasound use in dialysis access screening would considerably increase the number of stenoses diagnosed in-time. On the contrary, clinical suspicion on access stenosis is highly specific, therefore it is not indispensable to confirm it by ultrasound.