STUDY OF VASCULAR ACCESS BLOOD-FLOW BY ANGIODYNOGRAPHY

Angiodynography has been recommended as a safe and accurate way to det ermine the blood flow through hemodialysis vascular grafts. This infor mation might be used prophylactically to avert total graft occlusion. We examined the blood flows obtained by this technique after an interv al of 6 months in a group of hemodialysis patients whose grafts did no t require surgical or radiologic manipulation in the interim. No chang es in the mean blood flows were noted during the period of observation . Although a significant correlation was found between the original an d follow-up blood flows, the coefficient of determination was only 0.2 7. The Bland-Altman plot of these data showed that both large decrease s and increases in graft flows were recorded for many patients whose g raft function did not appear to worsen. Dialysis itself did not seem t o alter the measured blood flow. We conclude that caution must be used in interpreting changes in blood flow measured over time by angiodyno graphy. More study of the factors accounting for the variability in bl ood flow estimations by this technique are needed. (C) 1995 by the Nat ional Kidney Foundation, Inc.