Background: In patients with end stage renal disease (ESRD), the need for vascular access is mandatory to start hemodialysis (HD) as renal replacement therapy. Hemodialysis vascular access is the key point of the therapy. No working vascular access, no therapy.
Objective: To review the numerous roles played by Doppler Ultrasound Study (DUS) in post -operative evaluation of dialysis access function.
Patients and Methods: This study aimed to evaluate the role of color Doppler ultrasound in the detection and characterization of complications of arterio-venous fistula dialysis access. So, we included 50 patients with chronic renal failure and on regular hemodialysis who were referred from Benha Teaching Hospital Center for Nephrology and Dialysis within a period of twelve months from June 2019 to May 2020.
Results: According to dialysis acess type among patients in this study, it was AVF in 48% of patients, AVG in 10% of patients, and Arterio arterial graft in 2% of patients.
     Among our study population, the most common shunt complication associated with HD was access thrombosis (n=24, 48%). Diagnosis of thrombosis was established by absence of flow using color or pulsed Doppler together with hypoechoic or echogenic thrombus filling the lumen. The 2nd common diagnosis was stenosis (n=21, 42.0%). Pseudo-aneurysmal formation was detected in 12% of patients. Aneurysmal dilation was reported in 4% of patients, and dialysis induced Limb ischemia/high flow fistula was 4% of patients. The least common complication was Infection in 2% of patients.
Conclusion: Color duplex US accurately identified the site and nature of the problem, in dysfunctional arterio-venous fistula, and allowed the operator to plan the endovascular (or open) intervention.