{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:29:51Z","timestamp":1779316191372,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Successful haemodialysis is dependent on optimal arteriovenous (AV) access flow. Although 600\u2009ml\/min is frequently quoted as the critical level for functional flow volume (Qa) according to the National Kidney Foundation guideline, this may not be applicable for the different configurations of AV fistulas (AVF) or AV grafts (AVG). This study evaluates ultrasound derived Qa measurement in the inflow brachial artery to autologous AVF in the forearm radiocephalic and arm brachiocephalic\/basilic configurations in relation to significant flow related AV dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Five hundred and eleven duplex ultrasound (DUS) scans were analysed in 193 patients. The end points were therapeutic intervention and\/or thrombosis of AVF versus no complication within 3\u2009months of the scan. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold Qa of the brachial artery supplying the AVF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 511 scans, 155 scans were assigned to the intervention group, that is, AVF requiring intervention or thrombosing within 3\u00a0months of the DUS. Using ROC curve analysis, the area under the curve (AUC) for all AVF is 0.90 (CI: 0.88\u20130.93) with an optimal threshold Qa of 686\u2009ml\/min. In forearm AVF, the threshold Qa is 589\u2009ml\/min while in arm AVF the threshold Qa is 877\u2009ml\/min. Forearm Qa is statistically different from arm Qa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Forearm AVF Qa threshold at 589\u2009ml\/min is distinct from arm AVF Qa at 877\u2009ml\/min and these are predictive of the need for impending intervention or thrombosis due to flow\u2010limiting stenosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.14142","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T15:38:43Z","timestamp":1672760323000},"page":"175-180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Optimal flow volume measurements in forearm versus arm arteriovenous fistulas"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5608-5846","authenticated-orcid":false,"given":"Erwin","family":"Yii","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Clinical Sciences at Monash Health Monash University  Clayton Victoria Australia"},{"name":"Vascular Surgery Unit at Eastern Health Box Hill Hospital  Box Hill Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Limi","family":"Lee","sequence":"additional","affiliation":[{"name":"Vascular and Transplant Surgery Unit at Monash Health Monash Medical Centre  Clayton Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevan","family":"Polkinghorne","sequence":"additional","affiliation":[{"name":"Department of Nephrology at Monash Health Monash Medical Centre  Clayton Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Thwaites","sequence":"additional","affiliation":[{"name":"Vascular and Transplant Surgery Unit at Monash Health Monash Medical Centre  Clayton Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Saunder","sequence":"additional","affiliation":[{"name":"Vascular and Transplant Surgery Unit at Monash Health Monash Medical Centre  Clayton Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming Kon","family":"Yii","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Clinical Sciences at Monash Health Monash University  Clayton Victoria Australia"},{"name":"Vascular and Transplant Surgery Unit at Monash Health Monash Medical Centre  Clayton Victoria 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