StAFF
Research type
Research Study
Full title
A Randomized Trial of Initial Strategy of Acuseal versus Fistula First in Incident Patients Requiring Haemodialysis with Sub-Optimal Options for An Arteriovenous Fistula
IRAS ID
275310
Contact name
David Kingsmore
Contact email
Sponsor organisation
NHS GG&C
ISRCTN Number
ISRCTN31359167
Duration of Study in the UK
4 years, 0 months, 0 days
Research summary
Most patients with kidney failure require haemodialysis which is where the blood is removed from the body, cleaned and then returned. The key to this process is a good connection to the dialysis machine which will allow blood removal and return, and this is called vascular access.
There are 3 types of vascular access:
-A TCVC or "line" which is often used in emergencies however has the highest rate of infections, lasts the least amount of time and can lead to long term problems.- AVF or "fistula" is the best form of access with the longest lifespan and the least number of complications, however they are most difficult forms of access to get working with almost half of those created failing.
- ecAVG or "early cannulation arterio-venous graft" which can be used immediately and have a high success rate, however are considered higher maintenance and may not last very long.
There is uncertainty which is best, this study aims to determine which is the best form of access for patients who need to start haemodialysis within the next 6 months. Patients who enter the study will get either an AVF immediately or wait and get an ecAVG when needed. The decision will be made randomly. Both operations are commonly performed and have very good outcomes. The information gained from this study will inform how vascular access is provided in the future.
Consent will be sought for long term follow up via health record linkage.
REC name
West of Scotland REC 3
REC reference
22/WS/0177
Date of REC Opinion
27 Jan 2023
REC opinion
Further Information Favourable Opinion