Plethysmographic Forearm Blood Flow Studies in Maintenance Hemodialysis Patients with Radial Arteriovenous Fistulae

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Abstract
Bilateral forearm blood flow was measured in 12 patients with radial AVF undergoing maintenance hemodialysis by venipuncture technique. Standard water plethysmographic methods were used. Hand circulation was not occluded by a wrist cuff as this would decrease or stop flow through the AVF. Studies were performed 2 to 36 (mean 18) months after creation of the AVF, and repeated a year later in four patients. Mean gross forearm blood flow with the AVF was 242 ml/min (SD 41.8; SE 10.5); control (opposite arm) mean flow was 21.1 ml/ min (SD 7.9; SE 2.0). Mean AVF flow was 36.1 ml/min/100 ml forearm tissue (SD 14.7; SE 3.7); control mean was 3.5 ml/min/100 ml forearm tissue (SD 1.4; SE 0.4). Mean AVF/control blood flow ratio was 11.5/1.0 (SD 5.5; SE 1.4). After one year intervals flow increased in two patients, was unchanged in one and decreased in one. Mean AVF forearm volume was 13.2% (SE 1.6) greater than control. Blood flow with the AVF is similar to that reported with the external teflonsilastic arteriovenous shunt. It is not an excessive burden on cardiac function.

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