Blood temperature monitoring–guided vascular access intervention improved dialysis adequacy

Abstract

Objectives:

The aim of this study was to investigate whether blood temperature monitoring–guided vascular access intervention could improve dialysis adequacy.

Methods:

We retrospectively evaluated all patients who received outpatient-based prevalent hemodialysis patients (n = 84) in our artificial kidney room between January 2019 and October 2019. Through blood temperature monitoring, access blood flow was calculated every month and Kt/V was calculated every 3 months. The reference point was set at the time of vascular intervention in the patients (n = 27) who underwent intervention or at the middle of the study period in patients (n = 57) who did not undergo intervention. The mean blood temperature monitoring–estimated access flow and Kt/V before and after the reference point were calculated and compared.

Results:

Among 84 patients, 30 (35.7%) showed access flow rates of <500 mL/min, calculated by blood temperature monitoring during the study period. Twenty-seven patients (32.1%) underwent vascular intervention, of whom 24 (28.6%) showed access flow rates of <500 mL/min, 2 (2.4%) showed weak bruit or thrill incapable of needling, and 1 (1.2%) presented acute occlusion. Six patients (7.1%) whose access flow rates were <500 mL/min refused to undergo intervention. All angiographies in the patients whose access flow rates were <500 mL/min who underwent intervention showed a significant stenosis. The mean change in blood temperature monitoring–estimated access flow and Kt/V before and after vascular intervention was 483.3 ± 490.6 and 0.19 ± 0.21, respectively, which showed significant differences (all p < 0.05). A weak positive correlation between the mean change in blood temperature monitoring–estimated access flow and Kt/V was shown in all study patients by Pearson’s correlation analysis (r = 0.234, p = 0.033).

Conclusion:

Access flow estimation by blood temperature monitoring might identify candidates who require vascular intervention. Blood temperature monitoring–guided vascular intervention significantly improved access flow and dialysis adequacy.

Keywords

Access flow dialysis monitoring vascular access

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