Mrs Prabhjot Kaur Deol1
1Monash Health, , Australia
Biography:
bio to come
Abstract:
Background:
KDOQI guidelines recommend routine surveillance of arteriovenous fistulas (AVFs) and grafts (AVGs) to enable early detection of dysfunction and reduce thrombosis and access failure. Transonic ultrasound dilution technology offers a reliable, non-invasive method to measure access flow and detect recirculation—key indicators of vascular access health. Regular monitoring can identify stenosis and other flow abnormalities before they lead to cannulation difficulty or elevated venous pressures during dialysis.
Aim:
To evaluate outcomes of bimonthly Transonic monitoring in detecting AVF and AVG dysfunction in Monash Health dialysis units.
Methods:
From January 2025 to January 2026, patients at Cranbourne Community Hospital and Casey dialysis units underwent Transonic monitoring every two months. Surveillance triggers included high access flow (>2000 mL/min), and low access flow (<600 mL/min). Patients with abnormal results were referred to vascular access and renal teams for further assessment with diagnostic ultrasound and interventional management as required.
Results:
Twenty-nine patients had abnormal Transonic findings. Sixteen underwent diagnostic ultrasound: 6 for high flow and 10 for low flow. Nine patients required fistuloplasty, all associated with low access flow and confirmed stenosis. Early identification of abnormal flow enabled timely imaging and intervention before progression to thrombosis or significant cannulation complications. Low access flow had a high positive predictive value, with 90% of scanned patients requiring fistuloplasty.
Conclusion:
Bimonthly Transonic monitoring supported early detection of vascular access dysfunction, particularly low flow due to stenosis. This enabled prompt imaging and intervention, strengthened multidisciplinary coordination, improved staff confidence in escalation, and contributed to proactive dialysis access preservation.