Timing for Arteriovenous Fistula Creation and Its Effect on Target Organs in Patients With Chronic Renal Failure
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Renal Failure, Chronic
- Sponsor
- Shanghai Changzheng Hospital
- Enrollment
- 2200
- Primary Endpoint
- Primary and secondary patency rate of AVF
- Last Updated
- 11 years ago
Overview
Brief Summary
The timing for arteriovenous fistula (AVF) creation and its effect on target organs in patients with chronic renal failure will be investigated by multicenter prospective cohort. Lower estimated glomerular filtration rate (eGFR) patients (eGFR<10ml/min 1.73m2 for patients without diabetic kidney disease, and eGFR<15ml/min 1.73m2 for diabetic kidney disease) and higher eGFR patients (eGFR 10-15ml/min 1.73m2 for patients without diabetic kidney disease, and eGFR 15-20ml/min 1.73m2 for diabetic kidney disease) will be proposed to undertake AVF creation. Maturation rate and time of AVF will be followed up in 3 months; primary and secondary patency rate of AVF, AVF construction on cardiac structure, function, encephalopathy, cerebral vascular lesions and cognitive function will be followed up in the next 2 years. This multicenter will provide evidence to develop guideline of timing for AVF creation
Investigators
Changlin Mei
Professor, Director, Division of Nephrology
Shanghai Changzheng Hospital
Eligibility Criteria
Inclusion Criteria
- •Patients with chronic renal failure, without AVF creation;
- •Estimated glomerular filtration rate (eGFR) \<15ml/min 1.73m2 for patients without diabetic kidney disease, and eGFR\<20ml/min 1.73m2 for diabetic kidney disease;
- •All study subjects must agree to participate in the study and provide written informed consent.
Exclusion Criteria
- •Patients with the history of arteriovenous graft, or central venous catheter, or peritoneal dialysis catheter placement;
- •Contraindications to AVF construction:
- •Allen's Test is positive, or arterial diameter\<2 mm; venous diameter\<2.5 mm or venous occlusion/stenosis.
- •Local infection.
- •Have any other uncontrolled medical condition (severe heart failure, malignancy, severe coagulation disorders ).
- •Mental illness that makes the patients unable to complete the trial.
- •Female who is planning to become pregnant, who is pregnant and/or lactating, who is unwilling to use effective means of contraception.
Outcomes
Primary Outcomes
Primary and secondary patency rate of AVF
Time Frame: 2 years
Assessed by duplex ultrasound
Maturation rate of AVF
Time Frame: 3 months
Assessed by duplex ultrasound. A mature fistula has a flow of over 500 mL/min,is less than 0.6 cm below the surface of the skin, and has a minimal diameter of 0.6 cm
Secondary Outcomes
- AVF creation on ventricular volumes and left ventricular remodeling(2 years)
- AVF creation on AVF creation on brain MRI and cognitive functions(2 years)
- Maturation time of AVF(3 months)
- Complications of AVF(2 years)