Study of Single-Needle Distal Return Technique Compared to Standard Two-Needle Care for Long-Term Arteriovenous Fistula Use in Adults on Maintenance Hemodialysis

What this Trial Is About

Millions of people with kidney failure rely on a well-functioning arteriovenous fistula AVF for life-sustaining hemodialysis. The usual method uses two needles to access the AVF three times a week, but this can damage the vessel over time, causing scarring and failures that require painful and costly repair procedures. This study evaluates a new technique called Single-Needle Distal Return SNDR that uses only one needle in the AVF and returns blood through a vein in the lower leg or foot, aiming to reduce damage to the AVF. The study will enroll about 50 adults undergoing hemodialysis with a native AVF, who agree to try the SNDR method. Another similar group will continue with the standard two-needle AVF care for comparison. Each hemodialysis session uses either the SNDR method or the standard approach. The study will last around three years, including a 24-month follow-up period to assess outcomes. Participants will be closely monitored for dialysis effectiveness, safety, and practical benefits like fewer repair procedures and hospitalizations. Researchers will measure dialysis adequacy using KtV, track complications such as bruising or infection, and record dialysis machine alarms. Patient comfort and satisfaction will be assessed through questionnaires at 6, 12, and 24 months. Economic impacts and patient characteristics related to successful long-term use will also be studied.

Single-Needle Distal Return for Long-Term Arteriovenous Fistula Care