Randomized trial comparing two lengths of anastomosis in radio-cephalic arterio-venous fistulas (AVFs)

Randomized trial comparing 1-year AVF blood flow with two lengths of anastomosis in radio-cephalic AVFs in patients with advanced chronic kidney disease

Status

Not yet recruiting

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12626000881336

Enrollment

Registered

2026-07-17

Start date

2026-10-01

Completion date

2028-10-01

Last updated

2026-09-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Our goal is to determine whether reducing the anastomosis length of radio-cephalic AVFs can lower AVF blood flow at one year while still ensuring normal and timely maturation. We will perform an interventional randomized controlled trial with two parallel groups on the effect of AVF anastomosis length on AVF blood flow after 1 year. We will include patients with ESKD on hemodialysis or with advanced chronic kidney disease preparing for hemodialysis. Patients will be randomized in a 1:1 ratio into two groups 1) small anastomosis group (length of 5 mm) and 2) “standard” anastomosis group (length of 8 mm). The primary outcome will be estimated blood flow in the brachial artery (equivalent to AVF flow) at 1 year after AVF construction.

Interventions

surgical creation of arterio-venous fistula with small anastomosis (5 mm, measured intraoperatively); performed by nephrologist under local anaesthesia (approx. 2 hours procedure)

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Treatment

Masking

Open (masking not used) (Subject)

Eligibility

Sex/Gender

All

Age

18 Years to 75 Years

Healthy volunteers

Inclusion criteria

• planned construction of a distal radiocephalic AVF (anastomosis at the mid-forearm or more distally; not snuff-box; not proximal radiocephalic AVF; elbow or proximal radiocephalic AVF allowed in case of high radial artery bifurcation), • age >=18 and 1 year, • suitable artery (>=1.8 mm diameter, with at worst focal calcifications at site of planned anastomosis), • suitable vein (>=2.3 mm diameter, without variable diameter [suspicion of phlebitis]).

Exclusion criteria

• known advanced heart failure with severely reduced ejection fraction (EF <=35%), • planned AVF represents the patient’s last possible native vascular access.

Outcome results