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"Latar belakang: Fistula arteriovenous (FA V) merupakan akses terbaik untuk melakukan hemodialisis. Kegagalan maturasi fistula arteriovenous merupakan hambatan utama penggunaannya. Penelitian ini bertujuan menilai dapatkah bloodjlow rateyang diukur intraoperatif menggunakan ultrasonografi Doppler dapat menjadi prediktor maturitas F A V radiosefalika. Subjek dan Metode: Subjek adalah pasien-pasien yang akan dibuat F A V radiosefalika dengan usa mapping sesuai standar. Sesaat setelah anastonosis diukur bloodjlow ratedengan usa Doppler probe linear. Penelitian ini menggunakan desain potong lintanganalitik untuk mendapatkan hubungan maturasi FA V dengan bloodjlow rateintraoperatif.Hasil:FA V radiosefalika (n=71) pada 71 pasien dibuat dan dievaluasi dalam 6 minggu. Reratabloodjlow rateintraoperatif pada fistula yang matur secara signifikan lebih tinggi dibandingkan yang tidak matur (201,85 dan 141,96 mllmenit; P 165,5 ml/menit memiliki nilai prediktor yang baik untuk maturasi FA V radiosefalika,sehingga dapat menjadi acuan menentukan perlu tidaknya penilaian lebih lanjut dan tindakan revisi saat intraoperatif, yang pada akhimya diharapkan dapat menurunkan angka kegagalan maturasi fistula arteriovenous.

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Background: Arteriovenous fistula (A VF) is the best access to hemodialysis. The failure of arteriovenous fistula maturation is a major obstacle to its use. This study aims to assess whether an intraoperative bloodflow rate measured with Doppler ultrasound can be a predictor of the maturity ofradiocephalicA VF.Subjects and Methods: Subjects were patients to be made radiocephalic A VF with USG mapping according to the standard. Shortly after anastonosis bloodflow rate was measured with a linear probeDoppler ultrasound. This study used cross sectional analytic design to obtain radiocephalic A VF maturation relationship with intraoperative blood flow rate. Results: Radiocephalic A VF(n = 71) in 71 patients were made and evaluated in 6 weeks. The mean intraoperative blood flow rate in mature fistulas was significantly higher than those not mature (201.85 and 141.96 mLimin; P <0.001). Bloodflow rate with a cut-off value of 165.5 mLimin has a sensitivity of 93.8%, specificity 95.7%, positve predictive value 97.8% and negative predictive value 88.5%.Conclusion: Bloodflow rate> 165.5 mLimin has a good predictor value for radiocephalic A VF maturation, so it can be a reference to detem1inewhether the need for further assessment and revision action intraoperatively, which in tum is expected to decrease the maturation failure rate of arteriovenous fistula."

"Dewasa ini akses vaskular hemodialisis dan segala permasalahannya masih menjadi penyebab perawatan di rumah sakit dan morbiditas pada pasien gagal ginjal kronik. Dibalik keutamaan dan superioritas penggunaan fistula arteriovenous (AVF) sebagai akses vaskular hemodialisis, kegagalan maturasi merupakan hambatan utama penggunaannya. Penelitian ini bertujuan mengkaji dapatkah bloodflow rate (BFR) yang diukur intraoperatif menggunakan ultrasonografi Doppler memprediksi maturasi AVF. Metode penelitian adalah potong lintang. Hasil didapatkan BFR intraoperatif menggunakan ultrasonografi Doppler sesaat setelah kreasi AVF brakiosefalika dapat memprediksi maturasi dengan nilai titik potong sebesar 245,5 mL/menit, didapatkan nilai sensitifitas sebesar 76,7% , spesifisitas 92,9%, nilai duga positif 95,8% dan nilai duga negatif 65% sehingga dapat menjadi acuan menentukan perlu tidaknya tindakan revisi saat intraoperatif yang pada akhirnya diharapkan dapat menurunkan angka kegagalan maturasi AVF.

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Currently, vaskular access for haemodialysis and its assocoiated problems is the leading cause for hospital admission and morbidity in patients with chronic kidney failure. Arteriovenous fistula (AVF) is the preferred vaskular access for haemodialysis, however its use is impeded by issues of maturation. This cross sectional study aims to evaluate whether bloodflow rate (BFR), measured intraoperatively using Doppler ultrasonography, can predict AVF maturation. The result from this study showed that intraoperative BFR measured using Doppler ultrasonography right after the creation of the brachiocephalic fistula can predict the fistula’s maturation. The intraoperative BFR cut-off value was 245,5 mL/min, with sensititivity of 76,7%, specificity 92,9%, positive predictive value of 95,8% and negative predictive value 65%. Therefore, the intraoperative BFR may be used as a guide to decide whether or not a corrective procedure was needed to repair the brachiocephalic AVF, and consequently, help in reducing the rate of AVF maturation failure.

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"ABSTRAK Hemodialisis merupakan tatalaksana renal replacement yang tersering pada pasien gagal ginjal kronik stadium 5, Akses vaskular dan morbiditas sebagai akibat komplikasi akses merupakanpenyebab utama perawatan di rumah sakit. Kegagalan maturitas merupakan hambatan utamapenggunaan arteriovenous fistula. Tujuan dari penelitian ini adalah untuk mengkaji korelasi peaksistolik velocity arteri brakialis dan volume flow draining vein intraoperatif denganmenggunakan ultrasonografi doppler untuk memprediksi maturasi AVF. Uji statistik yangdigunakan adalah uji Mann Whitney dan uji Chi Squere. Hasil yang didapatkan tidak ditemukankorelasi antara PSV arteri brakialis dengan maturitas. Rerata nilai titik potong volume flowdraining vein intraoperatif 259,43 ml/min dan paska operatif 679,22 ± 65,36 ml/mindihubungkan dengan maturitas, ini dapat menjadi acuan menetukan perlu tidaknya melakukantindakan revisi saat intraoperatif, yang pada akhirnya diharapkan dapat menurunkan angkakegagalan maturasi AVF. ABSTRACT Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure."