Background: In the context of end-stage renal disease (ESRD), kidney transplantation and hemodialysis emerge as critical therapeutic avenues. However, the emergence of secondary complications is a prevailing concern. To address this, we undertook an innovative study utilizing sonography Doppler ARFI to comprehensively evaluate myopathy and the complexities associated with arteriovenous fistula (AVF) in ESRD patients.
Methods: We conducted a prospective observational study encompassing 65 ESRD patients who had undergone AVF for hemodialysis. The study was conducted in strict adherence to rigorous guidelines and received ethical and scientific committee approvals. A proficient team of radiologists carried out periodic assessments, employing ARFI values in tandem with ultrasonography and Doppler techniques. Patient evaluations were conducted at 0, 2, and 4 months subsequent to the creation of the AVF.
Results: The study cohort exhibited a distribution of 67.7% males and 32.3% females. The AVF placements encompassed 50.8% radial artery to cephalic vein connections and 49.2% brachial artery to cephalic vein connections. Initial AVF assessments at the onset (0 months) unveiled an absence of complications, with corresponding ARFI values well within the normal range. Progressing to the 2-month mark, 52.3% of patients displayed uncomplicated AVFs, indicative of proficient functionality and characterized by diminished ARFI values attributed to the steal phenomenon. Conversely, 47.5% of cases exhibited complications alongside normative ARFI values. Upon reaching the 4-month interval, 40% demonstrated uncomplicated AVFs with notably reduced ARFI values, while 60% presented complexities while still retaining ARFI values within the expected range.
Conclusion: Our study introduces a groundbreaking methodology for evaluating complications linked to AVFs through the utilization of sonography Doppler ARFI. The integration of ARFI values with Doppler techniques facilitated a comprehensive comprehension of both AVF successes and failures. The timely identification of myopathy significantly contributed to the efficacy of diagnoses and management strategies. Despite the relative scarcity of comparable research, our study differentiates itself through its systematic clinical rigor and technical methodologies within a tertiary medical environment. The outcomes of our study exhibit promising implications for elevating the prognosis of ESRD patients, consequently enhancing both their physical tolerance and overall quality of life.