| Clinical indicator . | Description . | References . |
|---|---|---|
| Physical exam | Ipsilateral extremity swelling; alterations in the pulse [e.g. weak downstream (distal) to the area of stenosis or bounding upstream (proximal) to it]; abnormal thrill (weak and/or discontinuous); abnormal bruit (high pitched); failure of the AV fistula to collapse when the arm is elevated (outflow stenosis) and lack of pulse augmentation (inflow stenosis) | [8–12] |
| Clinical findings at dialysis | Difficulty with cannulation; aspiration of clots; inability to achieve the prescribed dialysis blood flow in the absence of other clinical abnormalities; prolonged bleeding beyond usual for that patient from the needle puncture sites for three consecutive dialysis sessions; unexplained (>0.2 U) decrease in the delivered dialysis dose (Kt/V) or recirculation on a constant dialysis prescription without prolongation of dialysis duration | [9, 13] |
| Clinical indicator . | Description . | References . |
|---|---|---|
| Physical exam | Ipsilateral extremity swelling; alterations in the pulse [e.g. weak downstream (distal) to the area of stenosis or bounding upstream (proximal) to it]; abnormal thrill (weak and/or discontinuous); abnormal bruit (high pitched); failure of the AV fistula to collapse when the arm is elevated (outflow stenosis) and lack of pulse augmentation (inflow stenosis) | [8–12] |
| Clinical findings at dialysis | Difficulty with cannulation; aspiration of clots; inability to achieve the prescribed dialysis blood flow in the absence of other clinical abnormalities; prolonged bleeding beyond usual for that patient from the needle puncture sites for three consecutive dialysis sessions; unexplained (>0.2 U) decrease in the delivered dialysis dose (Kt/V) or recirculation on a constant dialysis prescription without prolongation of dialysis duration | [9, 13] |
Readers should be familiar with the physical exam of vascular access in order to be familiar with the range of normal features of hemodialysis access in order to detect abnormal findings and manifestations of access dysfunction [14, 15].
| Clinical indicator . | Description . | References . |
|---|---|---|
| Physical exam | Ipsilateral extremity swelling; alterations in the pulse [e.g. weak downstream (distal) to the area of stenosis or bounding upstream (proximal) to it]; abnormal thrill (weak and/or discontinuous); abnormal bruit (high pitched); failure of the AV fistula to collapse when the arm is elevated (outflow stenosis) and lack of pulse augmentation (inflow stenosis) | [8–12] |
| Clinical findings at dialysis | Difficulty with cannulation; aspiration of clots; inability to achieve the prescribed dialysis blood flow in the absence of other clinical abnormalities; prolonged bleeding beyond usual for that patient from the needle puncture sites for three consecutive dialysis sessions; unexplained (>0.2 U) decrease in the delivered dialysis dose (Kt/V) or recirculation on a constant dialysis prescription without prolongation of dialysis duration | [9, 13] |
| Clinical indicator . | Description . | References . |
|---|---|---|
| Physical exam | Ipsilateral extremity swelling; alterations in the pulse [e.g. weak downstream (distal) to the area of stenosis or bounding upstream (proximal) to it]; abnormal thrill (weak and/or discontinuous); abnormal bruit (high pitched); failure of the AV fistula to collapse when the arm is elevated (outflow stenosis) and lack of pulse augmentation (inflow stenosis) | [8–12] |
| Clinical findings at dialysis | Difficulty with cannulation; aspiration of clots; inability to achieve the prescribed dialysis blood flow in the absence of other clinical abnormalities; prolonged bleeding beyond usual for that patient from the needle puncture sites for three consecutive dialysis sessions; unexplained (>0.2 U) decrease in the delivered dialysis dose (Kt/V) or recirculation on a constant dialysis prescription without prolongation of dialysis duration | [9, 13] |
Readers should be familiar with the physical exam of vascular access in order to be familiar with the range of normal features of hemodialysis access in order to detect abnormal findings and manifestations of access dysfunction [14, 15].
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