George TO, Priester-Coary A, Dunea G, Daugirdas JT
Access recirculation by ultrasonic dilution compared to a 20 sec slow flow method
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Nov) 6:489 1995

In this study access recirculation (AR) was measured in 28 patients using the Transonics ultrasound dilution method and the urea slow flow method (15-20 sec of 50 ml/min flow). At a mean Qb of 350 ml/min, AR was detected in only 1/28 patients. The mean AR with the urea method was 3%, with occasional values to 10-20% which did not correspond to AR with ID. One patient had marked AR by both methods.

Comment: The lesson to be drawn is, that AR appears to be minimal or zero in the great majority of dialysis patients. A slight positive bias with the urea method may mean either a lack of sensitivity of ID for minimal AR, or a false positive urea AR due to detection of an early component of cardiopulmonary recirculation. (Daugirdas)

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Am Soc Nephrol
Basic hemodialysis : Vascular Access: graft/fistula