Background: Early identification of dysfunctional arteriovenous hemodialysis (HD) vascular access (VA) is important for timely referral and intervention.
Method: We retrospectively calculated the VA risk score using Vasc-Alert surveillance software technology from HD treatment sessions in 2 satellite HD units over 18 months. We included in the analysis HD patients dialyzing with arteriovenous fistula or graft (AVF/G) with available Vasc-Alert data for≥ 2 months. For group one (eventful) which included patients who developed vascular access thrombosis or stenosis over the study period, we collected Vasc-Alert risk score 2 months prior to the event, and for group two (uneventful) over 5 consecutive months. Vasc-Alert technology utilizes routinely collected data during HD to calculate the VA risk score and triggers an alert if the score is ≥7 in 3 consecutive dialysis sessions. Patients with> 2 alerts (vascular access score ≥ 7) per month were considered to have positive alerts.
Results: From 140 HD patients, 81 patients dialyzed via AVF/G. 77/81 had available Vasc-Alert data and were included in the final analysis. Out of 17 eventful patients, 11 (64.7%) had positive alerts 2 months prior to the vascular event. Out of the 60 patients without vascular events, 20 patients (33.3%) had positive alerts. Vasc-Alert's sensitivity and specificity for vascular events were 64.7% and 66.6% respectively. Within the 6 patients with thrombosed access, 2 patients (33.3%) detected by Vasc-Alert were not detected with clinical monitoring.
Conclusion: Vascular access risk score can be a useful non-invasive vascular access surveillance method to assist clinical decision-making.
The Author(s). Published by S. Karger AG, Basel.