{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:07:09Z","timestamp":1784531229094,"version":"3.55.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Arteriovenous fistulas (AVFs) are the preferred vascular access for hemodialysis but are prone to complications such as thrombosis, aneurysm, steal syndrome, and high-output heart failure. The Flow-to-Diameter Ratio (FDR), which integrates blood flow and vessel diameter, is a novel hemodynamic metric for AVF surveillance. This study evaluates FDR\u2019s association with AVF complications in hemodialysis patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study included 122 patients with radial-cephalic or brachial arteriovenous fistulas (AVFs) who had been on dialysis for \u2a7e5\u2009years. Data for these patients were collected between January 2022 and January 2024. Doppler ultrasound was used to measure blood flow and vessel diameter to calculate the FDR (mL\/min\/mm). Patients were categorized into low (&lt;100), normal (100\u2013300), and high (&gt;300) FDR groups. Complications were identified according to the KDOQI guidelines. Multivariate logistic regression and ROC curve analyses were used to assess FDR\u2019s predictive value of the FDR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean age was 64.5\u2009\u00b1\u200911.8\u2009years, and 58% had radial-cephalic AVFs. A high FDR (&gt;300\u2009mL\/min\/mm) was associated with a 50% complication rate in both AVF types, compared to 17% (radial-cephalic) and 18% (brachial) in the normal FDR group. Low FDR (&lt;100\u2009mL\/min\/mm) showed moderate complication rates (29% radial-cephalic, 22% brachial). High FDR independently predicted complications (radial-cephalic: OR: 2.38,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.015; brachial: OR: 2.51,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.013). ROC analysis showed AUCs of 0.82 (radial-cephalic) and 0.86 (brachial) at an FDR cutoff of 305\u2009mL\/min\/mm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The FDR is a robust predictor of AVF complications, with high values indicating an increased risk. Integrating FDR into Doppler surveillance may enhance risk stratification and guide timely intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298251389660","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T04:58:42Z","timestamp":1765774722000},"page":"1526-1532","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The role of flow-to-diameter ratio in predicting arteriovenous fistula complications in hemodialysis"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6326-663X","authenticated-orcid":false,"given":"Hakan","family":"G\u00fcven","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, VM Medical Park Hospital, Mudanya University, Vocational School, Bursa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211006972"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneph.2022.917265"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-023-02608-9"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-022-00542-7"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13239-017-0307-0"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298231180627"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211007720"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000415"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2017.09.08"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.13570"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.13062"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.5527\/wjn.v4.i1.6"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.001"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm021"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-023-03462-6"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.23.196"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016040412"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.043"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.14366\/usg.23064"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.02.001"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251389660","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298251389660","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251389660","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:49:20Z","timestamp":1784530160000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298251389660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,14]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/11297298251389660"],"URL":"https:\/\/doi.org\/10.1177\/11297298251389660","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,14]]}}}