Association between blood flow profiles and AVF failure in ESRDs.

• Research type

  Research Study

• Full title

  Is there an association between arterial spectral waveforms feature or flow profiles and arteriovenous fistula failure? A prospective pilot observational study.

• IRAS ID

  266564

• Contact name

  Usman Jaffer

• Contact email

  usman.jaffer@imperial.nhs.uk

• Sponsor organisation

  Imperial College NHS Healthcare Trust

• Clinicaltrials.gov Identifier

  N/A, N/A

• Duration of Study in the UK

  0 years, 5 months, 2 days

• Research summary

  In the UK, 30-50% of newly-created arteriovenous fistula (AVF) never mature to support
  dialysis and 25% fail after 2-years. Most of these (85%) occur when blood clot, also known
  as thrombus, cause poor circulation in fistula reducing the volume flow required for dialysis contributing to its failure. Currently, there are no accurate prognostic tests to predict whether a newly created fistula will fail to mature for timely secondary intervention and salvage.

  A non-Doppler assessment of blood flow profile (named as vector-AVF duplex) scan of the fistula, using a sensor and gel on the skin may be helpful in predicting whether a newly created fistula may never mature or whether a functioning fistula may fail by tracking “flow pattern” changes for salvage. This test is safe, painless and can be performed quickly at each dialysis session.

  The aims of the study are:

  - To determine whether arterial spectral waveforms feature are associated with arteriovenous fistula failure.
  - To evaluate whether flow profiles, as assessed by vector flow imaging techniques, are associated with arteriovenous fistula failure.

  Fifty end stage renal disease patients with newly-created (6-weeks post creation) or established fistulas will be scanned using the ultrasound scan. We will then extract information relating to the pattern of blood flow through the AVF. We will follow up patients by review of their clinical notes and records to note the working of their fistula at 3 and 6 months. We will then analyse the data to determine whether there is an association between flow profiles and AVF outcomes.

• REC name

  London - Surrey Borders Research Ethics Committee

• REC reference

  19/LO/1832

• Date of REC Opinion

  3 Jan 2020

• REC opinion

  Further Information Favourable Opinion