Assesment of Radial Artery by Means of Doppler Ultrasonography and Soft Tissue Roentgenogram in End-Stage Renal Disease Patients

Background: Although the radial artery (RA) is mostly selected for the creating of arterio-venous fistula (AVF) in end-stage renal disease patients (ESRDP), it still represents a suitable site to simply assess systemic calcification. Our goal of this study was to research the RA before the arteriovenous fistula creation in ESRDP and evaluate the risk factor determinants. Material and Methods: The RA has been determined to estimate vascular calcification in 67 ESRDPs on dialysis by doppler ultrasonography (USG). If there was any pathologic conditions, direct examination of the forehand soft tissue roentgenograms as a simply method was made. Preoperative spectral Doppler sonography measured radial artery peak systolic velocity during tight fist clenching for 3 minutes and after fist relaxation. Vessel diameters and peak systolic velocity were assessed for predictive value based on subsequent fistula adequacy. RA calcification was scored from Grade 0 which was defined as no calcification to Grade 4 which was described as severe calcification from proximal to distal end of RA. Results: Doppler USG has shown that the major or minor RA calcification was detected in 11 patients (16.5%). In these patients, direct roentgenogram also demonstrated RA calcific disease. Total and LDL cholesterol levels, gender and smoking status have no influence on calcification scores. When the dialysis periods are concerned, there was no correlation with the RA calcification. Serum calcium and phosphate levels, rather than calcium-phosphate products, and age were correlated with high calcification scores. The highest prevalence of RA calcification was also found in diabetic group. Conclusion: Our data indicate that RA calcification is highly prevalent among ESRDP, with the highest prevalence among diabetics. The RA was used as an A-V fistual creation in ESRDPs, which may be risky since the calcification percentage is higher. Therefore, a simple roentgenographic survey may help to identify patients with severe calcified RA. Because our roengenographyc results were correlated with doppler USG, it can be used to determine RA calcific disease before the arteriovenous fistula creation.