Estudo morfofuncional de fístulas arteriovenosas: uma abordagem com ultrassom ecodoppler

Abstract

Chronic Kidney Disease represents a major public health problem, and hemodialysis remains one of the main renal replacement therapies in the advanced stages of the disease. In this context, the arteriovenous fistula is considered the vascular access of choice, although it is subject to morphological and hemodynamic changes that may compromise its function. This study aimed to systematize the morphofunctional findings observed in ultrasound images of arteriovenous fistulas in individuals with Chronic Kidney Disease. This is an observational, cross-sectional, descriptive, and analytical study, based on the acquisition and analysis of ultrasound images of arteriovenous fistulas performed between November 2024 and April 2025 at the Hemodialysis Clinic of Hospital de S.o Francisco do Porto, Portugal. Autologous and prosthetic arteriovenous fistulas were evaluated considering morphological, structural, and hemodynamic aspects through B-mode, color Doppler, and spectral Doppler. The findings showed different ultrasonographic patterns, including fistulas with preserved flow, as well as alterations compatible with aneurysm, stenosis in a prosthetic segment, inflow stenosis, outflow stenosis, and thrombosis. These results show that Doppler ultrasound can identify structural changes and relevant hemodynamic repercussions in vascular access. It is concluded that ultrasound is a useful tool in the morphofunctional assessment of arteriovenous fistulas, contributing to the identification of patterns of normality and dysfunction, as well as to clinical follow-up and decision-making in the care of patients undergoing hemodialysis.