High resistive index of the radial artery is related to early primary radiocephalic hemodialysis fistula failure

Forty-nine patients who had received radiocephalic hemodialysis fistula con struction were evaluated with duplex Doppler ultrasonography to characteriz e the Doppler indices of the feed radial arteries just proximal to the site of anastomosis. Forty-four patients had fistulas with good function, and 5 patients had fistulas with inadequate blood flow or thrombosis within 4 we eks after the operation. A preliminary study showed extensive variability i n peak systolic velocity and end-diastolic velocity in the feed arteries. T he resistive index dropped significantly I week after the operation and rem ained relatively constant over the following 5 weeks. In the success group, the mean resistive index measured I week after operation was 0.40 +/- 0.06 . It was higher than that of the failure group (mean resistive index: 0.52 +/- 0.06). Among patients with well-functioning fistulas, diabetic patients had higher resistive indices than did non-diabetic patients (0.44 +/- 0.04 vs. 0.37 +/- 0.06). Our results suggest that a higher resistive index of t he feed artery is closely related to early autogenous primary hemodialysis fistula failure.