Arterial Stiffness as a Predictor for Arteriovenous Fistula Maturation
Research type
Research Study
Full title
Arterial Stiffness as a Predictor for Arteriovenous Fistula Maturation in Chronic Kidney Disease
IRAS ID
162933
Contact name
Peter Maxwell
Contact email
Sponsor organisation
Belfast Health and Social Care Trust
Duration of Study in the UK
1 years, 7 months, 31 days
Research summary
In order to carry out haemodialysis treatment, a means of transferring blood from the patient to the dialysis machine and then returning it back to the patient is required. The conduit directly related to the patient’s blood supply is termed a patient’s vascular access (VA).
There are three forms of vascular access:
a)Arteriovenous fistula (AVF), a connection between a native vein and artery.
b)Arteriovenous graft (AVG), a connection involving synthetic tubing and native blood vessels.
c)Central venous catheter (CVC), a cuffed catheter sited in a large neck vein.AVFs are currently the gold standard of VA as they are associated with improved patient survival, the best access longevity and the lowest complications. Unfortunately, following surgical creation 20-50% fail to mature and cannot be used. Poor native vessel structure, patient age, gender, medications and degree of surgical experience have been associated with failure of AVF maturation.
For an AVF to become functionally mature there must be sufficient delivery of blood to it via a good quality arterial vessel that will transmit its high pressure into an unrestricted, compliant and distensible vein. Following creation of an AVF the feeding arterial wall must dilate to accommodate significantly increased blood flow. It has been postulated that low arterial elasticity with poor dilatation impairs successful AVF development.
Pulse wave velocity (PWV) analysis is widely used as a non-invasive method of assessing arterial stiffness. Each heart beat generates a pulse wave, which is propagated to the extremities. PWV is calculated as the distance traveled by the pulse wave divided by the time taken to travel the distance. The stiffer the arterial wall, the faster the transmission of the pulse wave.
The aim of this study is to investigate the role of arterial stiffness measured using PWV analysis in predicting AVF maturation.REC name
Wales REC 7
REC reference
14/WA/1250
Date of REC Opinion
3 Dec 2014
REC opinion
Favourable Opinion