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Advanced Ultrasound Applications for Predicting AVF Outcomes

NCT04141358 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 76

Last updated 2026-03-04

No results posted yet for this study

Summary

Haemodialysis is a renal replacement therapy that can be introduced to patients with end-stage renal disease (ESRD) to help them maintain a good healthy life. The patient's blood is pumped through a dialysis machine to remove excess fluid, salt and waste, then it is pumped back into the patient's circulation system. In order to carry out haemodialysis, vascular access (VA) is required to connect the patient to the dialysis machine. Patients have only three options of vascular access: arteriovenous fistula (AVF), an anastomosis between a native vein and an artery; arteriovenous graft (AVG), a connection between a synthetic tube and native blood vessels; and (3) central line, a cuffed catheter placed in a large neck vein. Arteriovenous fistulas are the preferred method for VA because of their longevity and causing the least number of complications. Although there are a number of factors that may increase the probability of AVF failure rate such as age and gender of the patient, poor native vessel structure, medications and the level of surgical experience, 30-40% of new AVFs fail to mature for unknown reasons. For an AVF to become functionally mature postoperative, remodelling and dilation of the native artery and vein are essential to accommodate significantly increased blood flow. However, pre-existing diseases in patients with ESRD such as arterial stiffness and endothelial dysfunction may impair AVF and preclude dialysis. It has been asserted that the lack of AVF success is attributable to insufficient arterial dilation because of poor arterial wall elasticity.

The study aims to investigate the role of arterial stiffness and endothelial dysfunction in predicting AVF outcome using novel non-invasive ultrasound applications: 2D shear wave elastography and 2D strain speckle tracking will be employed to assess arterial stiffness, while an intraoperative flow-mediated dilation (FMD) technique will be used to evaluate endothelial dysfunction.

Conditions

  • End Stage Renal Diseases
  • Renal Failure
  • Chronic Kidney Diseases

Interventions

DIAGNOSTIC_TEST

Advanced ultrasound measurements

Clinical interventions and procedures: * Consent at 0 week * Clinical data collection at 0 week * Strain for native artery at 0 week * Young's modulus for native artery at 0 week * Intimal medial thickness for native artery at 0 week * Ultrasound blood volume flow measurement at 0 week * Vessel diameter at 0 week * Blood pressure at 0 week * BMI at 0 week * Intra-operative blood volume flow measurement at AVF surgery time * Strain for native artery at 6 weeks * Young's modulus native artery at 6 weeks * Intimal medial thickness native artery arteries at 6 weeks * Ultrasound blood volume flow measurement at 6 weeks * Vessel diameter at 6 weeks * Blood pressure at 6 weeks * BMI at 6 weeks

Sponsors & Collaborators

  • Imperial College London

    lead OTHER

Principal Investigators

  • Mohammed Aslam, PhD · Academic Supervisor

Eligibility

Min Age
18 Years
Max Age
90 Years
Sex
ALL
Healthy Volunteers
Yes

Timeline & Regulatory

Start
2021-11-01
Primary Completion
2024-04-01
Completion
2024-04-01

Countries

  • United Kingdom

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT04141358 on ClinicalTrials.gov