Role of Doppler Ultrasound in Assessment of Local Factors Affecting Maturation of Arteriovenous Fistula in Haemodialysis Patients

Background: The creation of a native arteriovenous fistula (AVF) is a crucial procedure for patients undergoing haemodialysis (HD). Doppler ultrasound (DUS) has recently been acknowledged as a standard method for vascular mapping, however it has been noted that there is a lack of evidence to support this recommendation. Objective: This study aimed to determine the efficacy of DUS in detecting the expected parameters associated with the maturation of AVFs in HD patients. Patients and methods: We performed DUS examinations on all AVFs created at our institute for this retrospective study. Patient characteristics as well as concomitant diseases and DUS parameters pre- and post-operative were analysed. Variables associated with maturation were analysed in multivariate models by logistic regression. Results: Successful maturation was observed in 58% of the patient cohort. Univariate analysis indicated that a larger diameter of the selected vein and a shorter distance between the vein and artery preoperatively were significantly associated with successful maturation (P = 0.032 and 0.047, respectively). Both the diameters of the outflow vein and inflow artery, along with the fistula flow volume, were significantly elevated in patients who achieved successful maturation (p=0.00). The multivariable logistic regression analysis indicated that the diameters of both the outflow vein and inflow artery, along with the blood flow volume at the fistula site post-surgery, significantly influenced the successful maturation. Conclusions: The importance of DUS aids in evaluating the risk of failure, thereby enhancing the durability of vascular access and improving patient outcomes.