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"Introduction: Steal syndrome that occurs due to vascular access is one of the most feared complications after making a fistula arteriovenous (FAV). It is necessary to develop an assessment for early detection. Hand ischemia questionnaire (HIQ) and measurement of peak systolic velocity (PSV) of the radial artery and the ulnar artery are a form of subjective and objective examinations used to detect steal syndrome. The aim is to determine the correlation between HIQ and PSV of the radial artery and ulnar artery in hemodialysis patients with upper arm’s native FAV to detect symptoms of steal syndrome. Method: This is a cross-sectional study conducted in Cipto Mangunkusumo National Hospital from March to May 2019. Patients undergoing hemodialysis using upper arm native access FAV with or without symptoms of ischemia in the hands were included. Patients were asked to fill HIQ by interview, and then continued with measurement of PSV of the radial arteries and distal ulnar arteries from the hands with FAV. Results: A total of 80 samples were taken with 43 were women (53.8%), and 37 were men (46.2%). About 91.2% of the samples were FAV at the brachiocephalic level. The median age of the samples was 53 years. From the total HIQ score obtained, the results were a minimum of 0, maximum of 70, and a median value of 3. PSV of radial artery were minimum of 20 cm/s, maximum of 79 cm/s, and median 40 cm/s. The minimum PSV of the ulnar artery was 16 cm/s, the maximum was 70 cm/s, and the median was 41 cm/s. There was a significant correlation between the hand ischemia questionnaire and the peak systolic velocity of the radial artery and the ulnar artery in patients with native upper arm FAV (p <0.001), but after diagnostic testing, it was found that sensitivity was only 15% and specificity was 100%. Conclusion: There was a significant correlation between hand ischemia questionnaire and peak systolic velocity of the radial artery and ulnar artery in patients with upper arm native FAV, but due to the low sensitivity, the hand ischemia questionnaire cannot be used as an initial examination to detect steal syndrome in patients with no symptoms of hand ischemia."

"Introduction: Hemodialysis is an essential treatment in patients with stage 5 chronic kidney disease (CKD) or End-Stage Renal Disease (ESRD). The maturity of arteriovenous fistulas determines the success of hemodialysis. FAV maturity depends on preoperative preparation. The study aims to examine the preoperative and intraoperative peak systolic velocity (PSV) of the radial artery as a predictor of the successful maturation of the radiocephalic FAV. Method: This study used an analytic cross-sectional design to obtain the relationship of FAV maturation with preoperative and intraoperative PSV. Subjects were those who will undergo radiocephalic FAV surgery with preoperative ultrasound mapping. Shortly after anastomosis, PSV was measured. After 6 weeks, FAV was assessed for its maturity. Results: As many as 71 patients were undergone radiocephalic FAV surgery and followed for six weeks. The mean preoperative PSV of mature fistula was significantly higher than immature (54.6 ± 11.7 cm/s and 26.7 ± 7.7 cm/s; p <0.001). The mean intraoperative PSV of mature fistula was significantly higher than immature (57.9 + 12.6 cm/s and 27.1 + 8.1 cm/s; p <0.001). The mean PSV difference in mature fistulas was significantly higher than immature (3 cm/s and 0 cm/s; p <0.001). Preoperative PSV with a cut-off of 40 cm/s, intraoperative with a cut-off of 2 cm/s, and a difference of PSV with a cut-off of 42 cm/s all had 92.9% accuracy as a predictor of FAV maturation compared to “rule of 6” as a reference standard."