Reducing Hemodialysis Catheter Use in Prevalent Hemodialysis Patients
Summary
To determine if a protocolized approach to converting hemodialysis central venous catheters (CVC) to arteriovenous fistulae will improve rates of functioning AVF and decrease CVC use.
Description
In order to receive dialysis, patients require repeated access to their bloodstream. This access can be either via a central venous catheter (CVC) or a surgically created arteriovenous fistula (AVF) or graft (AVG). This is a pilot randomized control trial of prevalent hemodialysis patients with a central venous catheter (CVC), to determine if a systematic approach using an algorithm protocol to convert the CVC to an AVF (arteriovenous fistula) will improve rates of functioning AVF and decrease CVC use. The algorithm (intervention group) will be compared to current practice (control group), a non-standardized approach at the discretion of the caring nephrologist and/or surgeon.
Study Design
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Conditions
Hemodialysis
Intervention
Protocolized approach to convert dialysis catheter to fistula
Location
Health Sciences Centre
Winnipeg
Manitoba
Canada
R3A1R9
Status
Recruiting
Source
University of Manitoba
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT01053117
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Renal Dialysis
Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.
Hemodialysis Solutions
Solutions prepared for hemodialysis. The composition of the pre-dialysis solution may be varied in order to determine the effect of solvated metabolites on anoxia, malnutrition, acid-base balance, etc. Of principal interest are the effect of the choice of buffers (e.g., acetate or carbonate), the addition of cations (Na+, K+, Ca2+), and addition of carbohydrates (glucose).
Intestinal Fistula
An abnormal anatomical passage between the INTESTINE, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as STOMACH (gastrocolic fistula), the BILIARY TRACT (cholecystoduodenal fistula), or the URINARY BLADDER of the URINARY TRACT (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (MEDICAL ERRORS).
Hemodialysis Units, Hospital
Hospital units in which care is provided the hemodialysis patient. This includes hemodialysis centers in hospitals.
Vaginal Fistula
An abnormal anatomical passage that connects the VAGINA to other organs, such as the bladder (VESICOVAGINAL FISTULA) or the rectum (RECTOVAGINAL FISTULA).
Clinical Trials
The primary objective of the study is to examine the risk of catheter dysfunction during the dialysis session that follows the instillation of ethanol 60% as lock solution in tunneled sili...
Access Creation for Hemodialysis: Association With Structural Changes of the Heart
The purpose of this study is to determine if the creation of a fistula or a graft plays a role in the development of heart disease for patients undergoing hemodialysis
The Effect of Different Dosages of Solute Clearance on Outcome in Twice Weekly Hemodialysis Patients
Adequacy of solute clearance makes a profound impact on clinical outcome in maintenance hemodialysis patients. Thus far, guidelines on the target of solute clearance (Kt/V or URR) are base...
Ex Vivo Microbiological Assessment of an Anti-biofilm Catheter in Acute Dialysis Application
The clinical study aims at providing data on antimicrobial efficiency and a supposed additional preventive effect on catheter-related infections of a catheter with antibacterial surface co...
The primary objective of this study is to compare two treatment strategies for establishing dialysis access in patients with unsuitable forearm veins for the standard forearm primary radio...
PubMed Articles
Femoral arteriovenous fistula 3 months after removal of catheter for hemodialysis.
A 56-year-old Asian woman was admitted to hospital for the consideration of hemodialysis (HD). A right femoral dialysis catheter was inserted for HD. Three months after removal of catheter, she was ad...
Management of the immature autogenous arteriovenous fistula.
A high-quality autogenous arteriovenous fistula provides the optimal access for hemodialysis. Following initial surgical construction of a fistula, the maturation process is driven by hemodynamic, cel...
Patients with central venous occlusion who are "tunneled catheter dependent" are a challenge for hemodialysis access. A relatively new option for them is the hemodialysis reliable outflow (HeRO) devic...
Central venous catheterization is frequently performed for perioperative management and long-term intravenous access. Although complications associated with central venous catheter insertion have been...
Computational Flow Dynamics and Preclinical Assessment of a Novel Hemodialysis Catheter.
We examined flow characteristics and recirculation of a novel dialysis catheter with helically contoured lumens, which optimize the vectors of blood entering and leaving the device. Computational flow...
