{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:37:58Z","timestamp":1788863878825,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2018,9]]},"abstract":"\n Background and objectives<\/jats:title>\n Postoperative ultrasound is commonly used to assess arteriovenous fistula (AVF) maturation for hemodialysis, but its utility for predicting unassisted AVF maturation or primary AVF patency for hemodialysis has not been well defined. This study assessed the predictive value of postoperative AVF ultrasound measurements for these clinical AVF outcomes.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n We queried a prospective vascular access database to identify 246 patients on catheter-dependent hemodialysis who underwent AVF creation between 2010 and 2016 and obtained a postoperative ultrasound within 90 days. Multivariable logistic regression was used to evaluate the association of clinical characteristics and postoperative ultrasound measurements with unassisted AVF maturation. A receiver operating characteristic curve estimated the predictive value of these factors for unassisted AVF maturation. Finally, multivariable survival analysis was used to identify factors associated with primary AVF patency in patients with unassisted AVF maturation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Unassisted AVF maturation occurred in 121 out of 246 patients (49%), assisted maturation in 55 patients (22%), and failure to mature in 70 patients (28%). Using multivariable logistic regression, unassisted AVF maturation was associated with AVF blood flow (odds ratio [OR], 1.30; 95% confidence interval [95% CI], 1.18 to 1.45 per 100 ml\/min increase;\n P<\/jats:italic>\n <0.001), forearm location (OR, 0.37; 95% CI, 0.08 to 1.78;\n P<\/jats:italic>\n =0.21), presence of stenosis (OR, 0.45; 95% CI, 0.23 to 0.88;\n P<\/jats:italic>\n =0.02); AVF depth (OR, 0.88; 95% CI, 0.77 to 1.00 per 1 mm increase;\n P<\/jats:italic>\n =0.05), and AVF location interaction with depth (OR, 0.50; 95% CI, 0.28 to 0.84;\n P<\/jats:italic>\n =0.02). The area under the receiver operating characteristic curve, using all these factors, was 0.84 (95% CI, 0.79 to 0.89;\n P<\/jats:italic>\n <0.001). Primary AVF patency in patients with unassisted maturation was associated only with AVF diameter (hazard ratio, 0.84; 95% CI, 0.76 to 0.94 per 1 mm increase;\n P<\/jats:italic>\n =0.002).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Unassisted AVF maturation is predicted by AVF blood flow, location, depth, and stenosis. AVF patency after unassisted maturation is predicted only by the postoperative AVF diameter.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.02230218","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T09:55:29Z","timestamp":1535018129000},"page":"1364-1372","source":"Crossref","is-referenced-by-count":36,"title":["Postoperative Ultrasound, Unassisted Maturation, and Subsequent Primary Patency of Arteriovenous Fistulas"],"prefix":"10.2215","volume":"13","author":[{"given":"Crystal A.","family":"Farrington","sequence":"first","affiliation":[{"name":"Division of Nephrology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Robbin","sequence":"additional","affiliation":[{"name":"Department of Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timmy","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Nephrology,"},{"name":"Veterans Affairs Medical Center, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Barker-Finkel","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Allon","sequence":"additional","affiliation":[{"name":"Division of Nephrology,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,8,23]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jvs.2016.02.033","article-title":"Outcomes of arteriovenous fistulas and grafts with or without intervention before successful use.","volume":"64","author":"Harms","year":"2016","journal-title":"J Vasc Surg"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1111\/j.1523-1755.2002.kid551.x","article-title":"Increasing arteriovenous fistulas in hemodialysis patients: Problems and solutions.","volume":"62","author":"Allon","year":"2002","journal-title":"Kidney Int"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1159\/000343669","article-title":"Most important chronic complications of arteriovenous fistulas for hemodialysis.","volume":"22","author":"Stolic","year":"2013","journal-title":"Med Princ Pract"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1053\/j.semvascsurg.2016.08.005","article-title":"Future research directions to improve fistula maturation and reduce access failure.","volume":"29","author":"Hu","year":"2016","journal-title":"Semin Vasc Surg"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"291","DOI":"10.5301\/jva.5000210","article-title":"Accuracy of early postoperative clinical and ultrasound examination of arteriovenous fistulae to predict dialysis use.","volume":"15","author":"Ferring","year":"2014","journal-title":"J Vasc Access"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1148\/radiol.2251011367","article-title":"Hemodialysis arteriovenous fistula maturity: US evaluation.","volume":"225","author":"Robbin","year":"2002","journal-title":"Radiology"},{"key":"B7-20230813","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S1078-5884(96)80108-0","article-title":"Factors associated with early failure of arteriovenous fistulae for haemodialysis access.","volume":"12","author":"Wong","year":"1996","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B8-20230813","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1159\/000013315","article-title":"Effects of age and diabetes on blood flow rate and primary outcome of newly created hemodialysis arteriovenous fistulas.","volume":"18","author":"Lin","year":"1998","journal-title":"Am J Nephrol"},{"key":"B9-20230813","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1053\/ajkd.2002.33394","article-title":"Native arteriovenous fistula: Preoperative evaluation.","volume":"39","author":"Malovrh","year":"2002","journal-title":"Am J Kidney Dis"},{"key":"B10-20230813","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1177\/1538574407312648","article-title":"Expected flow parameters within hemodialysis access and selection for remedial intervention of nonmaturing conduits.","volume":"42","author":"Back","year":"2008","journal-title":"Vasc Endovascular Surg"},{"key":"B11-20230813","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.crad.2016.02.025","article-title":"Predicting the maturity of haemodialysis arteriovenous fistulas with colour Doppler ultrasound: A single-centre study from China.","volume":"71","author":"Zhu","year":"2016","journal-title":"Clin Radiol"},{"key":"B12-20230813","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1148\/radiol.2463061942","article-title":"Clinically immature arteriovenous hemodialysis fistulas: Effect of US on salvage.","volume":"246","author":"Singh","year":"2008","journal-title":"Radiology"},{"key":"B13-20230813","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/112972980901000107","article-title":"Pre-operative vessel mapping and early post-operative surveillance duplex scanning of arteriovenous fistulae.","volume":"10","author":"Ives","year":"2009","journal-title":"J Vasc Access"},{"key":"B15-20230813","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1148\/radiology.217.1.r00oc2883","article-title":"US vascular mapping before hemodialysis access placement.","volume":"217","author":"Robbin","year":"2000","journal-title":"Radiology"},{"key":"B16-20230813","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.1046\/j.1523-1755.2001.00031.x","article-title":"Effect of preoperative sonographic mapping on vascular access outcomes in hemodialysis patients.","volume":"60","author":"Allon","year":"2001","journal-title":"Kidney Int"},{"key":"B17-20230813","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/1744-9987.12601","article-title":"Two-stage basilic vein transposition: Second stage results.","volume":"22","author":"Rego","year":"2018","journal-title":"Ther Apher Dial"},{"key":"B18-20230813","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.jvs.2014.11.083","article-title":"Similar failure and patency rates when comparing one- and two-stage basilic vein transposition.","volume":"61","author":"Cooper","year":"2015","journal-title":"J Vasc Surg"},{"key":"B19-20230813","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.2215\/CJN.02740313","article-title":"Preoperative venous intimal hyperplasia, postoperative arteriovenous fistula stenosis, and clinical fistula outcomes.","volume":"8","author":"Allon","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"B20-20230813","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/S0272-6386(04)01085-6","article-title":"Vascular access stenosis: Comparison of arteriovenous grafts and fistulas.","volume":"44","author":"Maya","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"B21-20230813","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1038\/sj.ki.5000129","article-title":"Randomized comparison of ultrasound surveillance and clinical monitoring on arteriovenous graft outcomes.","volume":"69","author":"Robbin","year":"2006","journal-title":"Kidney Int"},{"key":"B22-20230813","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1046\/j.1523-1755.1998.00761.x","article-title":"A multidisciplinary approach to hemodialysis access: Prospective evaluation.","volume":"53","author":"Allon","year":"1998","journal-title":"Kidney Int"},{"key":"B23-20230813","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1148\/radiol.2015150385","article-title":"Arteriovenous fistula development in the first 6 weeks after creation.","volume":"279","author":"Robbin","year":"2016","journal-title":"Radiology"},{"key":"B24-20230813","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1053\/j.ajkd.2003.09.015","article-title":"Highly increased cell proliferation activity in the restenotic hemodialysis vascular access after percutaneous transluminal angioplasty: Implication in prevention of restenosis.","volume":"43","author":"Chang","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"B25-20230813","doi-asserted-by":"crossref","first-page":"501","DOI":"10.2215\/CJN.11531116","article-title":"Definitions and end points for interventional studies for arteriovenous dialysis access.","volume":"13","author":"Beathard","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B26-20230813","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1053\/j.ajkd.2017.10.027","article-title":"Relationships between clinical processes and arteriovenous fistula cannulation and maturation: A multicenter prospective cohort study.","volume":"71","author":"Allon","year":"2018","journal-title":"Am J Kidney Dis"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01277230-201809000-00011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:38:35Z","timestamp":1786369115000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01277230-201809000-00011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,23]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.02230218","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,23]]}}}