#3866 PREOPERATIVE ASSESSMENT FOR VASCULAR ACCESS: VASCULAR MAPPING AND HANDGRIP STRENGTH

Abstract

Abstract Background and Aims A reliable vascular access (VA) is required for patients receiving chronic hemodialysis (HD) treatment. VA choice is complex and must consider patient characteristics, predicted patency and risk of primary failure. Vascular mapping (VM) by duplex doppler ultrasonography (DUS) can aid in the planning of which VA to place. Peripheral artery disease (PAD) is associated with higher AVF failure and can be assessed by calculating the ankle-brachial index (ABI). Muscle strength is independently associated with mortality risk and can be evaluated with handgrip strength (HGS). This study aims to describe and analyze clinical anthropometric and laboratory characteristics of patients referred for vascular mapping prior to VA creation and to correlate VM data, HGS, and ABI. Method Prospective analysis of all adult patients with CKD who were referred for VM, at a tertiary center, between March 2021 and August 2021. No patients were excluded. Preoperative DUS by a single experienced nephrologist was carried out. HGS was measured using a Hand Dynamometer and PAD was defined as ABI<0.9. According to distal vasculature size (<2mm) sub-groups were analyzed. Results 80 patients were included and 67.5% were male, mean age 65.7 ± 14.7 years and 51.3% were on Renal Replacement Therapy (RRT). Twelve (15%) participants had PAD. HGS was higher in dominant arm (20.5 ± 12.0 kg vs 18.8 ± 11.2 kg). Fifty-eight (72.5%) patients had vessels smaller than 2 mm in diameter. There were no significant differences between groups concerning demographic and comorbidities (diabetes, PAD). HGS was significantly higher in patients who had vessels greater than or equal to 2 mm in diameter (26.1 ± 15.5 kg vs 18.4 ± 9.7 kg, p = 0.010). Conclusion Greater HGS was associated with more developed distal vessels. Low HGS might be an indirect sign of poor vascular characteristics, which might help predict the outcomes of VA creation and maturation.