Abstract
Blood flow of brachial artery, radial artery, cephalic vein (shunting vein) and ulnar artery was measured by a real time ultrasonic duplex system and clinically evaluated in 71 hemodialyzed patients. Volume blood flow (VBF) of the shunt side was greater than that of the normal side. Mean VBF in the shunt side of the brachial artery was 737.3m1/min and that of the radial artery was 570.8m1/min. VBF in the group with side-to-side anastomosis was greater than VBF in the group with side-to-end or end-to-end anastomosis. Mean shunting vein VBF in the group with side-to-side, side-to-end and end-to-end anastomosis was 916.2m1/min, 554.2ml/min, and 430.4m1/min, respectively. At the ulnar artery, VBF in the group with end-to-end anastomosis was less than that of the groups with side-to-side or side-to-end anastomosis. In the groups with side-to-side or side-to-end anastomosis, the direction of blood flow through the radial artery was reversed and toward the anastomosis at the peripheral site. This fact indicates that additional blood flow through the palmar arches contributes to increased shunt flow through both the side-to-side and the side-to-end anastomoses. In comparison with pathogenesis of chronic renal failure, diameters of radial artery and shunting vein in the group with diabetic nephropathy were less than those of the group with chronic nephritis, but there was no significant difference in VBF. Shunt flows ranged from 100 to 1000m1/min for the patients with no shunt complications. High output heart failure developed in two cases with a side-to-side anastomosis and, the shunt flows proved to be above 2000m1/min. Flow measurement by the ultrasonic duplex system is non-invasive, easy to handle and useful for long term follow up of hemodialyzed patients.
