Role of Regular Surveillance on Maintenance of Patency of an Arteriovenous Access

Study Overview
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Brief Summary
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Chronic Kidney disease (CKD) is a worldwide public health problem that classified into five stages (1). End stage renal disease (CDK stage 5) patients require a well-functioning vascular access (VA) for successful hemodialysis treatment (2). Types of VA include arteriovenous fistulae (AVFs) and arteriovenous grafts (AVGs). A vascular access is liable to early or late complications, and ultimately access failure. A meta-analysis showed that a 17% mean early access failure However recent studies have shown higher failure rates of up to 46%, with one year patencies between 52% to 83% (3). Low VA flow, thrombosis and loss of patency may result in under-dialysis that leads to increased morbidity, mortality and healthcare expenditure (4). In the majority of VAs, stenoses develop over variable intervals causing VA thrombosis and failure (5). If early detected and corrected, VA function and patency can be preserved and under-dialysis can be minimized or avoided. The aim of this study is to find out the role of periodic surveillance of VA in the detection of VA dysfunction and correctable lesions that may necessitate pre-emptive interventions to maintain VA patency and prevent VA loss

Official Title
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Role of Regular Surveillance on Maintenance of Patency of an Arteriovenous Access

Conditions
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Hemodialysis Access Failure

Intervention / Treatment
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* Device: duplex ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ESRD Patients have functioning or failing VAs (AVFs or AVGs). Exclusion Criteria: ESRD patients have infected or failed VAs . patientrefusal .

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ESRD Patients have functioning or failing VAs (AVFs or AVGs).<br> | Device: duplex ultrasound<br>* regular duplex follow up every three months with subsequent intervention either diagnostic venography , angioplasty or surgery according to the type of the lesion<br>* Other names: surgery;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number, type and technical success rate for elective interventions |  | within one year of creation of the VA | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| secondary patency rate of the Arteriovenous Access after elective intervention |  | within one year of creation of the VA | 
| number , type of complication that resulted from elective interventions |  | within one year of creation of the VA | 
| primary patency rate of newly created Arteriovenous Access in assiut governorate |  | within one year of creation of the VA |