After reviewing and comparing various methods of surveillance of AV grafts and fistulas, a London, Ontario group of physicians concluded that Transonic’s ultrasound indicator dilution methodology (Kriviski Method) is the gold standard for measurement of vascular access recirculation and access flow. It is the method of choice for monthly surveillance of vascular access grafts in adherence to NKF-KDOQI guidelines.
The advantages of the Transonic ultrasound dilution technique are:
- It is easy to use;
- Immediate answers are provided;
- Measurements are accurate;
- It can measure delivered blood flow;
- Measurements can be integrated into the dialysis session.
Disadvantages of indicator dilution technology might be its expense and the necessity of having a dedicated person to take the measurements.
They conclude that available evidence would suggest that access flow measurements are the best tests currently available to screen for access dysfunction. Together, with successful preventative interventions such as angioplasty and surgery, indicator dilution access flow measurements should be regarded as the standard of care.
Garland JS, Moist LM, Lindsay RM, “Are Hemodialysis Access Flow Measurements by Ultrasound Dilution the Standard of Care for Access Surveillance?,” Advances in Renal Replacement Therapy 2002; 9(2) 91-98. (Transonic Reference # HD263A)