Abstract
Vascular access recirculation (R) is a well-known cause of decreased dialysis dose. In this paper a new easy protocol for R detection in pre-dialysis derived from the classic Glucose Infusion Test (GIT) is introduced. The pre-dialysis GIT (GIT-pre) is based on the glucose (5%, 10 ml) bolus injection directly into the venous needle and on a simultaneous withdrawal from the arterial needle. If the glucose value increases during the glucose bolus, R is present. This new protocol was validated on 29 chronic haemodialysis patients (20 AVFs, 7 CVCs, 2 PTFE grafts), comparing the glucose increase with the classic GIT during dialysis. Only one CVC had R with the blood lines in the normal position (Aglu = 465 mg/dl with GIT-pre and a Δglu = 186 mg/dl, R = 9.3% with classic GIT) while in the reverse blood line position, all CVCs showed a significant glucose increase (mean GIT-pre Δglu = 195 mg/dl; mean GIT Δglu = 140 mg/dl corresponding to a R = 8%). There were 5 AVFs with true R (correct blood lines position) clearly identified by both methods (mean values Δglu = 316 mg/dl with GIT-pre and a Δglu = 390 mg/dl, R = 19.5% with classic GIT). Preliminary results show good reliability of the new protocol in identifying VA R caused either by failing VA with stenosis or by reverse blood lines position. The GIT-pre is a simpler application of the classic GIT useful for testing new VA, new needle positions or CVC performance before starting dialysis. A simpler R test could increase the frequency of the measurements and consequently the power of R in early detection of VA problems.
| Original language | English |
|---|---|
| Pages (from-to) | 191-193 |
| Number of pages | 3 |
| Journal | EDTNA-ERCA Journal |
| Volume | 31 |
| Issue number | 4 |
| Publication status | Published - Oct 2005 |
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Keywords
- Glucose Infusion Test
- Recirculation
- Vascular access
ASJC Scopus subject areas
- Nephrology
Cite this
Pre-dialysis application of the glucose infusion test for recirculation detection. / Libori, Cinzia; Spallazzi, M.; Bono, M.; Brozzo, C.; Celsi, M.; Grisanti, S.; Iaria, B.; Pellegrotti, D.; Pensierini, D.; Magnasco, A.
In: EDTNA-ERCA Journal, Vol. 31, No. 4, 10.2005, p. 191-193.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pre-dialysis application of the glucose infusion test for recirculation detection
AU - Libori, Cinzia
AU - Spallazzi, M.
AU - Bono, M.
AU - Brozzo, C.
AU - Celsi, M.
AU - Grisanti, S.
AU - Iaria, B.
AU - Pellegrotti, D.
AU - Pensierini, D.
AU - Magnasco, A.
PY - 2005/10
Y1 - 2005/10
N2 - Vascular access recirculation (R) is a well-known cause of decreased dialysis dose. In this paper a new easy protocol for R detection in pre-dialysis derived from the classic Glucose Infusion Test (GIT) is introduced. The pre-dialysis GIT (GIT-pre) is based on the glucose (5%, 10 ml) bolus injection directly into the venous needle and on a simultaneous withdrawal from the arterial needle. If the glucose value increases during the glucose bolus, R is present. This new protocol was validated on 29 chronic haemodialysis patients (20 AVFs, 7 CVCs, 2 PTFE grafts), comparing the glucose increase with the classic GIT during dialysis. Only one CVC had R with the blood lines in the normal position (Aglu = 465 mg/dl with GIT-pre and a Δglu = 186 mg/dl, R = 9.3% with classic GIT) while in the reverse blood line position, all CVCs showed a significant glucose increase (mean GIT-pre Δglu = 195 mg/dl; mean GIT Δglu = 140 mg/dl corresponding to a R = 8%). There were 5 AVFs with true R (correct blood lines position) clearly identified by both methods (mean values Δglu = 316 mg/dl with GIT-pre and a Δglu = 390 mg/dl, R = 19.5% with classic GIT). Preliminary results show good reliability of the new protocol in identifying VA R caused either by failing VA with stenosis or by reverse blood lines position. The GIT-pre is a simpler application of the classic GIT useful for testing new VA, new needle positions or CVC performance before starting dialysis. A simpler R test could increase the frequency of the measurements and consequently the power of R in early detection of VA problems.
AB - Vascular access recirculation (R) is a well-known cause of decreased dialysis dose. In this paper a new easy protocol for R detection in pre-dialysis derived from the classic Glucose Infusion Test (GIT) is introduced. The pre-dialysis GIT (GIT-pre) is based on the glucose (5%, 10 ml) bolus injection directly into the venous needle and on a simultaneous withdrawal from the arterial needle. If the glucose value increases during the glucose bolus, R is present. This new protocol was validated on 29 chronic haemodialysis patients (20 AVFs, 7 CVCs, 2 PTFE grafts), comparing the glucose increase with the classic GIT during dialysis. Only one CVC had R with the blood lines in the normal position (Aglu = 465 mg/dl with GIT-pre and a Δglu = 186 mg/dl, R = 9.3% with classic GIT) while in the reverse blood line position, all CVCs showed a significant glucose increase (mean GIT-pre Δglu = 195 mg/dl; mean GIT Δglu = 140 mg/dl corresponding to a R = 8%). There were 5 AVFs with true R (correct blood lines position) clearly identified by both methods (mean values Δglu = 316 mg/dl with GIT-pre and a Δglu = 390 mg/dl, R = 19.5% with classic GIT). Preliminary results show good reliability of the new protocol in identifying VA R caused either by failing VA with stenosis or by reverse blood lines position. The GIT-pre is a simpler application of the classic GIT useful for testing new VA, new needle positions or CVC performance before starting dialysis. A simpler R test could increase the frequency of the measurements and consequently the power of R in early detection of VA problems.
KW - Glucose Infusion Test
KW - Recirculation
KW - Vascular access
UR - http://www.scopus.com/inward/record.url?scp=33646539838&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33646539838&partnerID=8YFLogxK
M3 - Article
C2 - 16551023
AN - SCOPUS:33646539838
VL - 31
SP - 191
EP - 193
JO - Journal of Renal Care
JF - Journal of Renal Care
SN - 1019-083X
IS - 4
ER -