Measurement of Hemodialysis Access Recirculation

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Abstract
Conventional methods of measuring recirculation in hemodialysis access include a three site method performed during dialysis, and a two site technique conducted at the end of a hemodialysis treatment. This study describes a two site procedure performed at the beginning of a hemodialysis session. Blood samples are drawn from the arterial side of the hemodialysis access immediately prior to hemodialysis (AIPD), and from the same arterial line (A+5) and venous line (V+5) when maximal blood flows are reached 5 min after starting hemodialysis. Blood urea nitrogen (BUN) is measured in these samples, and the results entered into the formula AIPD—A+5/A,IPD – V+5 ± 100% to calculate the percent recirculation. Percent recirculation calculated by this method compared favorably with, and may hold several advantages over conventional techniques.

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