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Access Complication Predictions for AV Fistula and AV Graft

By Daniel Foster10 May 2024

Recently, a group of researchers performed a retrospective study to quantify the stenotic and thrombotic predictive power of Ultrasound Dilution Technology (UDT) for AV fistulas and AV grafts. Due to debate in recent years, this study was intended to assess the potential value of integrating UDT measurements into standard hemodialysis access monitoring protocols.

The study included 397 patients (336 patients with arteriovenous fistula and 61 patients with arteriovenous graft), who, throughout 2017, received quarterly access flow surveillance measurement followed by comparative physical examination to evaluate the predictive ability of UDT in detecting stenosis in both fistulas and grafts.

During 2017, 106 of the arteriovenous fistula patients received percutaneous transluminal angioplasty procedures and 63 arteriovenous graft patients received the same—outcomes that were closely predicted in both cases by UDT measurements. Specifically, using thresholds of <400ml/min and <600ml/min respectively, UDT measurements returned an accuracy of 91.54% for predicting stenosis in arteriovenous fistula patients, and 72.15% accuracy in predicting stenosis in arteriovenous graft patients. Additionally, in the researcher’s words “…The use of a relative threshold, defined as blood flow < 1000 mL/min and a 25% decline in blood flow, did not affect the predictive performance of blood flow surveillance models.”1 (Per 2006 KDOQI guidelines.)


Transonic commends the researchers for taking a direct approach to a long-overdue assessment. The statistics clearly confirm what Transonic has espoused for decades: that UDT is an excellent predictor of stenosis, and beyond this study, vascular access problems of all sorts. We invite you to take a closer look at the technology here, to see the incredible difference you can make in your dialysis patient care with the Transonic HD03.

Thanks for reading,

                Transonic Systems Inc,

                        The Measure of Better Results



  1. Wu, CK., Lin, CH. Integrating vascular access surveillance with clinical monitoring for stenosis prediction. J Nephrol(2023). https://doi.org/10.1007/s40620-023-01799-2