[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-422573-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-422573-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","detailed-ultrasonographic-assessment-of-calcified-arteries-before-arterio-venous-fistula-construction-and-fistula-outcomes-a-prospective-observational-study","Detailed ultrasonographic assessment of calcified arteries before arterio-venous fistula construction and fistula outcomes - a prospective observational study","","Arterial calcifications, especially mediocalcinosis, are common in hemodialysis patients and can limit forearm arterio-venous fistula (AVF) construction, impair maturation, and increase the risk of hemodialysis access-induced distal ischemia (HAIDI). This prospective observational study evaluates detailed ultrasound characteristics of calcified arteries and links them to AVF outcomes. It assesses calcification grade, color Doppler homogeneity, compressibility, and Doppler parameters at rest and during reactive hyperemia, using ultrasound findings to guide AVF site planning.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/detailed-ultrasonographic-assessment-of-calcified-arteries-before-arterio-venous-fistula-construction-and-fistula-outcomes-a-prospective-observational-study/422573/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/detailed-ultrasonographic-assessment-of-calcified-arteries-before-arterio-venous-fistula-construction-and-fistula-outcomes-a-prospective-observational-study/422573.png","ImageObject",300,407,{"name":42,"@type":43},"awa","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What problem does the study address about calcified arteries in hemodialysis patients?","Question",{"text":63,"@type":64},"Severe arterial calcifications can reduce the feasibility of constructing a forearm AVF, lower maturation rates, and raise the risk of HAIDI.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which ultrasound features are assessed before planning AVF construction?",{"text":68,"@type":64},"The study evaluates calcification grade on B-mode, color Doppler homogeneity, artery compressibility, and pulsed-wave Doppler parameters at rest and during reactive hyperemia.",{"name":70,"@type":61,"acceptedAnswer":71},"What were the main outcome findings for AVF maturation and HAIDI?",{"text":72,"@type":64},"Constructed AVFs/grafts showed very good maturation rates (>75%), and there were no clinically significant HAIDI cases reported.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},422573,1791224748,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146,"preview_page_count":4},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Gubensek etal. BMC Nephrology (2026) 27:2 [https://doi.org/10.1186/s12882-025-04660-9](https://doi.org/10.1186/s12882-025-04660-9)  \nBMC Nephrology  \nRESEARCH Open Access  \nDetailed ultrasonographic assessment of calcified arteries before arterio-venous fistula construction and fistula outcomesa prospective observational study  \nJakob Gubensek 1,2*, Denis Fornazaric 1,2 and Matej Zrimsek 1,2  \nAbstract  \nBackground Arterial calcifications (mainly mediocalcinosis) are highly prevalent in patients on hemodialysis. Severe calcifications reduce the possibility of a forearm arterio-venous fistula (AVF) construction, reduce maturation rates and increase the risk of hemodialysis access-induced distal ischemia (HAIDI) . We report a prospective observational study on detailed ultrasound assessment of calcified arteries and outcomes of AVFs constructed in those conditions. Methods In patients referred for vascular mapping, distal, mid and proximal radial artery (RA) as well as brachial artery were assessed for grade of calcifications (B-mode), homogeneity of color Doppler (CD) and compressibility of the artery. Pulsed-wave Doppler parameters at rest and during reactive hyperemia were also assessed. Based on the results, a site for AVF construction was planned. Outcomes of constructed AVFs were assessed.  \nResults In 35 patients (mean age 68±13 years, 89% diabetics) we assessed 240 arterial sites, made 44 plans and constructed 31 AVFs/grafts. We observed several ultrasonographic phenotypes of calcified arteries. Severely calcified arteries (B-mode assessment) were heterogeneous when assessed for CD homogeneity and compressibility. Constructed AVFs/grafts had very good maturation rates (> 75%) even in a subgroup of radio-cephalic AVFs made on significantly calcified RAs (79%) . There were no cases of clinically significant HAIDI.  \nConclusions AVF construction with high likelihood of maturation and low likelihood of HAIDI in patients with significantly calcified arteries is possible, after proper evaluation of the artery. Homogeneity of CD and compressibility of the artery with ultrasound probe are useful additional criteria for assessing the suitability of a severely calcified artery for AVF construction.  \nKeywords Arterial calcifications, Maturation rate, Reactive hyperemia, Ultrasound assessment, Vascular access  \n*Correspondence:  \nJakob Gubensek  \n[jakob.gubensek@kclj.si](jakob.gubensek@kclj.si)  \n1Center for Acute and Complicated Dialysis and Vascular Access, Department of Nephrology, University Medical Center Ljubljana, Zaloskacesta 7, Ljubljana 1000, Slovenia  \n2Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/.  \nIntroduction  \nArterial calcifications (mainly in the form of mediocalcinosis) are common in patients with advanced stages of chronic kidney disease (CKD) or end-stage kidney disease. In addition to the CKD itself, advanced age, longstand","cbCaigETethcStWx","https://ap.wps.com/l/cbCaigETethcStWx","pdf",2872314,11,"English","# Abstract\n# Background\n# Methods\n# Results\n# Conclusions\n# Keywords\n# Introduction","[{\"question\":\"What problem does the study address about calcified arteries in hemodialysis patients?\",\"answer\":\"Severe arterial calcifications can reduce the feasibility of constructing a forearm AVF, lower maturation rates, and raise the risk of HAIDI.\"},{\"question\":\"Which ultrasound features are assessed before planning AVF construction?\",\"answer\":\"The study evaluates calcification grade on B-mode, color Doppler homogeneity, artery compressibility, and pulsed-wave Doppler parameters at rest and during reactive hyperemia.\"},{\"question\":\"What were the main outcome findings for AVF maturation and HAIDI?\",\"answer\":\"Constructed AVFs/grafts showed very good maturation rates (\\u003e75%), and there were no clinically significant HAIDI cases reported.\"}]","Detailed ultrasonographic assessment of calcified arteries before arterio-venous fistula construction and fistula outcomes - a prospective observational study | PDF",1790627996,28]