Evaluation of Needle Bevel Orientation During Arteriovenous Fistula Puncture in Adults Undergoing Hemodialysis for End-Stage Renal Disease

What this Trial Is About

End-stage renal disease ESRD is a serious condition where kidney function declines, requiring dialysis or transplantation. The number of people undergoing dialysis is rising with an aging population. This research focuses on patients with ESRD undergoing hemodialysis, specifically evaluating how the orientation of the needle bevel during arteriovenous fistula AVF puncture affects complications. The study aims to identify the most conservative puncture technique to reduce risks associated with repeated AVF punctures. Participants will be randomly assigned to one of two groups for the entire study duration of 24 months. One group will have AVF punctures performed with the needle bevel facing up, while the other group will have the bevel facing down. The study involves routine hemodialysis sessions three times a week with double needles. The study will observe the impact of these two techniques on AVF complications, dysfunction, interventions, survival, wall thickening, and patient discomfort. During the study, participants will receive hemodialysis at a dialysis center and be monitored regularly over 12 to 24 months. Assessments include the occurrence of AVF complications during dialysis, ultrasound evaluations, interventions, and patient pain reports. Caregivers feedback on puncture techniques will also be collected. The primary outcome focuses on complications during dialysis over 12 months, with additional evaluations continuing up to 24 months to understand long-term effects and AVF survival.

Impact of Bevel Orientation on Arteriovenous Fistula Puncture in Hemodialysis