End stage renal disease. End stage renal disease
Conditions
Interventions
Intervention 1: Control group: creation of distal radiocephalic fistula with end vein-to-side artery technique. A longitudinal incision is made in distal forearm and the radial artery and cephalic vei
Sponsors
Esfahan University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: The patient is referred for the first time by a nephrologist for of permanent hemodialysis access implantation . Clinical examination of both upper limbs should confirm all of the following criteria: 1) Presence of the cephalic vein in distal third of forearm 2) Presence of the radial pulse 3) Presence of the ulnar pulse 4) Positive Allen's test 5) Cephalic vein and radial artery in distal third of forearm are not more than 2 cm apart. Preoperative arteriovenous mapping by Doppler ultrasound confirms all of the following criteria: 1) Patent cephalic vein with a minimum diameter of 2.5 mm in distal third of forearm, with no stenosis and a minimum continuity of 15 cm 2) Patent radial artery, with a minimum diameter of 2 mm in distal third of forearm, free of stenosis and major calcifications 3) Patent ulnar artery, free of stenosis and major calcifications 4) Positive Allen's test as confirmed by retrograde flow test (patent palm arch) 5) Cephalic vein and radial artery in distal third of forearm are not more than 2 cm apart. Patient's informed consent to participate in the study.
Exclusion criteria
Exclusion criteria: Patients under guardianship Evidence of concomitant central venous obstruction at the time of referral
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary patency. Timepoint: 6 months. Method of measurement: Clinical examination and duplex ultrasonography. | — |
Secondary
| Measure | Time frame |
|---|---|
| Primary patency. Timepoint: 12 months. Method of measurement: Clinical examination and duplex ultrasonography.;Secondary patency. Timepoint: 6 and 12 month. Method of measurement: Clinical examination and duplex ultrasonography.;Maturation of AVF. Timepoint: 3 and 6 months. Method of measurement: Duplex ultrasonography.;Incidence of complications. Timepoint: 1 year. Method of measurement: Checklist, clinical examination and duplex ultrasonography.;1-year reintervention rate. Timepoint: 12 months. Method of measurement: Questionnaire and medical records of patients.;1-year cumulative patency. Timepoint: 12 months. Method of measurement: Clinical examination, duplex ultrasonography and medical records of patients. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactDr. Morteza Shahbandari
Esfahan University of Medical Sciences
Outcome results
None listed