Prospective Analysis of Arteriovenous Access (AVA) Use in Continuous Renal Replacement Therapy: A Feasibility Project

Starting soon · Not applicable

Conditions studied: Continuous Renal Replacement Therapy (CRRT), End Stage Kidney Disease (ESRD)

In brief

This study will test whether patients who already have a permanent dialysis access (an arteriovenous fistula or graft) can safely use that access for continuous dialysis (CRRT) while they are critically ill in the intensive care unit, instead of requiring a temporary central venous catheter. About 50 patients will participate. Researchers will monitor how well the access works, whether any complications occur, and whether there are differences between fistulas and grafts. The goal is to determine whether using a patient's existing dialysis access is a safe and practical option that could reduce the need for temporary catheters and their associated risks, such as infection and bleeding.

Key facts

Study ID

NCT07447128

Run by

East Carolina University

People needed

50

Starts

2026-07-27

Expected to finish

2027-12-31

Last updated by the study team

2026-07-06

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age ≥18 years.
• ESKD patients on chronic hemodialysis for >1 year in duration who are admitted to the ICU and in need of CRRT.
• Anticipated CRRT duration ≥24 hours, based on clinical assessment of the renal trajectory.
• Patient with functioning arteriovenous access, either arteriovenous fistula or arteriovenous graft.
• Expected mechanical ventilation for a minimum of 12 hours, based on clinical assessment of the underlying diagnosis.
• Expected Richmond Agitation Sedation Scale (RASS) goal of 0 or less for a minimum of 12 hours, based on clinical assessment of the underlying diagnosis.
• Patients able to tolerate placement of an arm board at the vascular access site.
• Baseline AVA blood flow of at least 600 mL/min for AVG and 500 mL/min for AVF during ultrasonography evaluation upon enrollment.

You may not qualify if…

• Age less than 18 years old.
• Patients who receive dialysis via hemodialysis catheter or existing central catheter suitable for hemodialysis.
• ESKD patients who, at the time of enrollment, have a sacral pressure ulcer or other clinically significant skin integrity impairment requiring frequent repositioning, extensive patient rotation, or advanced wound care management.
• Patients with elevated INR above 5 at the time of study enrollment.
• Patients with acute liver failure, defined as AST >1000 U/L and/or ALT >1000 U/L at the time of study enrollment.
• Patients with a platelet count of less than 50,000 (10⁹ plt/L) at the time of study enrollment.
• Patients with evidence of disseminated intravascular coagulation at the time of study enrollment.
• Known pregnancy at the time of study enrollment.
• Patients at high risk for rapid clinical deterioration, or those deemed unsuitable for AVA-based CRRT by the prescribing nephrologist or ICU physician.

Where it is running

• East Carolina University Medical Center — Greenville, North Carolina, United States

Full record on ClinicalTrials.gov

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