Clinical importance of color doppler ultrasonography in preoperative assessment of hemodialysis vascular access creation

Chronic kidney failure is characterized with progressive and ireversible diminishing of glomerular filtration rate. Arterio-venous fistula (AVF) for hemodialysis should be created in patients with endogenous creatinine clearance ≤ 20 mL/min/1,73m2. Inner diameter of a. radialis ≥ 2.0 mm, inner diameter of v.cephalica ≥ 2.5 mm, flow velocity through the a.radialis - VmaxS ≥ 50 cm/s and flow through the a. radialis - Qa.radialis ≥ 40 mL/m intenable adequate maturing of distal radio-cephalic AVF. Diameter of v.cephalica ≥ 4.0 mmand blood flow Q AV ≥ 500 mL/min, four weeks after the AVF creation, indicate adequately matured AVF and possibility of puncturing it. Maximal blood flow velocity through AVF of 100-350 cm/s and blood flow of 500-1000 mL/min, are signs of good function of AVF and adequate hemodialysis. Color Doppler ultrasonography enables preoperative planning of AVF, early complication detection, choice of appropriate therapeutical procedure for complication treatment, estimation of maturation, prime time for puncture and AVF function, which all contribute to a significant morbidity decrease and better life quality in hemodialysis patients.