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Vascular access (VA), often labeled the lifeline of the hemodialysis patient, is a critical part of the management of end -stage renal disease (ESRD)1. Optimal VA care is necessary to avoid underdialysis and VA loss, undoubtedly leading to increased morbidity, mortality, and health-care -associated costs2,3. VA monitoring was defined by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) as the examination and evaluation of the VA using the physical examination to detect signs that suggest the presence of dysfunction2. On the other hand, surveillance consists of periodic evaluation through the use of one or more tests that may require special instrumentation and for which an abnormal result suggests the presence of dysfunction2.

Doppler Ultrasound in Vascular Access care: the pearls and pitfalls of flow volume measurement