Can pre and postoperative vein diameter and postoperative flow velocities influence the patency of vascular access in hemodialysis patients?

Introduction: All end-stage renal disease patients have to undergo renal replacement therapy or renal transplantation. Patients require vascular access for hemodialysis. Autologous arteriovenous fistula (AVF) is the gold standard to maintain vascular access for hemodialysis. Methods: This is a prospective study. A total of 187 patients were evaluated in this study. Correlation with pre- and postoperative vein diameter and flow velocities on the outcomes of the AVFs was studied. Pre- and postoperative vein diameter and postoperative flow velocities were measured on the 1st-postoperative day in vein and across anastomosis using duplex Doppler study. Results: Flow velocities across the anastomosis and the vein were significant in both radiocephalic (RC) and brachiocephalic (BC) group. P = 0.010 and 0.013 for RC and 0.046 and 0.004 for the BC group, respectively. Increase in the postoperative vein diameter between functioning and nonfunctioning group was significant, with P = 0.029 in the BC group. Flow velocities in vein and across anastomosis between functioning and failure group were significant in brachiobasilic (BB) fistulas with P = 0.0220 and 0.0143, respectively. Increase in the postoperative vein diameter between functioning and nonfunctioning group is not significant, with P = 0.446. Conclusion: The increase in vein diameter after anastomosis predicts the success of fistula in BC AVF. Flow velocities in vein and across anastomosis have strong prediction in RC, BC, and BB AVF