イチバ　シンゴ   Ichiba Shingo   市場　晋吾    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Evaluating the need for and effect of percutaneous transluminal angioplasty on arteriovenous fistulas by using total recirculation rate per dialysis session ("clearance gap").
掲載誌名	正式名：Acta medica Okayama 略　 称：Acta Med Okayama ISSNコード：(0386-300X)0386-300X(Linking)
掲載区分	国内
巻・号・頁	66(6),pp.443-7
著者・共著者	Ugawa Toyomu, Sakurama Kazufumi, Yorifuji Takashi, Takaoka Munenori, Fujiwara Yasuhiro, Kabashima Narutoshi, Azuma Daisuke, Hirayama Takahiro, Tsukahara Kohei, Morisada Sunao, Iida Atsuyoshi, Tada Keitaro, Shiba Naoki, Sato Nobuo, Ichiba Shingo, Kino Koichi, Fukushima Masaki, Ujike Yoshihito
発行年月	2012
概要	The functioning of an arteriovenous fistula (AVF) used for vascular access during hemodialysis has been assessed mainly by dilution methods. Although these techniques indicate the immediate recirculation rate, the results obtained may not correlate with Kt/V. In contrast, the clearance gap (CL-Gap) method provides the total recirculation rate per dialysis session and correlates well with Kt/V. We assessed the correlation between Kt/V and CL-Gap as well as the change in radial artery (RA) blood flow speed in the fistula before percutaneous transluminal angioplasty (PTA) in 45 patients undergoing continuous hemodialysis. The dialysis dose during the determination of CL-Gap was 1.2 to 1.4 Kt/V. Patients with a 10% elevation or more than a 10% relative increase in CL-Gap underwent PTA (n = 45), and the values obtained for Kt/V and CL-Gap before PTA were compared with those obtained immediately afterward. The mean RA blood flow speed improved significantly (from 52.9 to 97.5cm/sec) after PTA, as did Kt/V (1.07 to 1.30) and CL-Gap (14.1% to -0.2%). A significant correlation between these differences was apparent (r = -0.436 and p = 0.003). These findings suggest that calculating CL-Gap may be useful for determining when PTA is required and for assessing the effectiveness of PTA, toward obtaining better dialysis.
PMID	23254578