An arteriovenous (AV) access is the Achilles heel of hemodialysis. Its complications account for up to 50% of first year HD costs and approximately 25 percent of all hospitalization costs. The cost of this AV access morbidity has been estimated to be ~$8,000 per patient year at risk.¹

Flow-Based Access Patency Management

Transonic Flow-QC^® surveillance, integrated into a clinic’s AV access patency management program:

• results in better detection and elective treatment of stenosis, lower thrombosis rates and improved access patency rates;²
• reduces costs due to decreased hospitalizations, surgical interventions, catheters placed, and missed treatments.³

One European study reported that Transonic Flow-QC® reduced total costs per patient-year by 32%.⁴

ESRD Vascular Access Costs

Vascular access complications constitute a significant portion of ESRD Medicare costs ($7.045 billion in 2006). USRDS Annual Data Reports of the USA patient population were analyzed to tabulate cost differences between ESRD patients managed with Transonic Flow-QC^® (TQC) access flow surveillance per KDOQI
Guidelines⁵, and those managed under any guidelines, but without TQC. The study concluded that early treatment and avoiding serious complications could save the Medicare program approximately $700 million each year. Estimated five-year total cost savings would be $3.1 billion and ten-year total savings could reach $7.1 billion.⁶*

Annual Cost Comparison for Patients with and without Transonic Flow-QC Surveillance under KDOQI Guidelines⁶

Cardiac Function Management

High vascular access flow increases cardiac index and leads to high-output cardiac failure.⁷ A low cardiac index leads to cardiogenic shock.8 Both
result in costly ICU admissions and interventions. Transonic Flow-QC^® Cardiac Function Monitoring supports proactive cardiac assessment to avert
sudden cardiac dysfunction or progressive cardiac failure and subsequent associated costs.

References

1. Lok, CE et al, Reducing vascular access morbidity: a comparative trial of two vascular access monitoring strategies. Nephrol Dial Transplan. 2003; 18:1174-1180.
2. Tessitore N, Adding access blood flow surveillance to clinical monitoring reduces thrombosis rates, costs, and improves fistula patency in the short term: a controlled cohort study. Nephrol Dial Transplan 2008; 23:3578-3584.
3. McCarley P et al, Vascular access blood flow monitoring reduces access morbidity and costs. Kidney Int. 2001; 60:1164-1172.
4. Wijnen E, Impact of a quality improvement programme based on vascular access flow monitoring on costs, access occlusion and access failure. Nephrol Dial Transplan. 2006; 21:3514-3519.
5. http://www.kidney.org/professionals/kdoqi/guideline_uphd_pd_va/va_guide4.htm NFK KDOQI Guidelines (2006)
6. Xanthopoulos J, Analysis of Medicare Cost Savings for End-stage Renal Disease Patients on Hemodialysis. 2009.*
7. Basile C, The relationship between the flow of arteriovenous fistula and cardiac output in HD patients. Nephrol Dial Transplant 2008; 23:282-287.
8. Braunwald E editor. Heart Disease: A Textbook of Cardiovascular Medicine, 5th ed. Philaldelphia: W.B. Saunders Co.1997.