Abstract: FR-PO520
Comparative Evaluation of UAB and NKF-KDOQI Criteria for Predicting Unassisted Arteriovenous Fistula Maturation Using Postoperative Ultrasound Measurements
Session Information
- Dialysis Vascular Access
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Chae, Seung Yun, The Catholic University of Korea Seoul St Mary's Hospital, Seoul, Seocho-gu, Korea (the Republic of)
- Kim, Yaeni, The Catholic University of Korea Seoul St Mary's Hospital, Seoul, Seocho-gu, Korea (the Republic of)
- Park, Hoon suk, The Catholic University of Korea Seoul St Mary's Hospital, Seoul, Seocho-gu, Korea (the Republic of)
Background
This study aimed to compare the predictive performance of the University of Alabama at Birmingham (UAB) criteria with the NKF-KDOQI guidelines in forecasting unassisted arteriovenous fistula (AVF) maturation. Additionally, we sought to evaluate how the predictive accuracy of these criteria varies between upper arm AVFs and forearm AVFs.
Methods
We retrospectively analyzed the age, gender, BMI, and comorbidities of chronic kidney disease patients who underwent AVF creation and were monitored from January 2017 to March 2021 at a single medical center. Additionally, we assessed the types of AVFs, the success rate of the first cannulation, and postoperative AVF ultrasound measurements.
Results
Among the 560 patients analyzed, 68.6% experienced unassisted AVF maturation. Specifically, upper arm AVFs had a higher unassisted maturation rate (70.2%) compared to forearm AVFs (66.8%). The NKF-KDOQI guidelines had a higher positive predictive value for overall unassisted AVF maturation (0.85) than the UAB criteria (0.77), while UAB showed a better negative predictive value (0.57). Receiver Operating Characteristic Curve analysis revealed that UAB (AUC = 0.643, 95% CI 0.602–0.684) outperformed NKF-KDOQI (AUC = 0.56, 95% CI 0.532–0.589) in predicting overall AVF maturation. For forearm AVFs, UAB (AUC = 0.654, 95% CI 0.593–0.715) also demonstrated superior predictive ability compared to NKF-KDOQI (AUC = 0.517, 95% CI 0.494–0.540), which was close to random chance.
Conclusion
In conclusion, the UAB criteria proved superior in predicting the overall unassisted maturation of AVFs compared to the NKF-KDOQI guidelines. This was especially evident for forearm AVFs, where the predictive ability of the NKF-KDOQI criteria for unassisted maturation was nearly random.
ROC curve : Forearm AVF