BMJ Open (Jul 2019)

Surveillance arterioveNous fistulAs using ultRasound (SONAR) trial in haemodialysis patients: a study protocol for a multicentre observational study

  • Samantha Hyndman,
  • Helena Edlin,
  • Emma Laing,
  • Edward CF Wilson,
  • Subash Somalanka,
  • James Hunter,
  • James Richards,
  • Mohammed Hossain,
  • Dominic Summers,
  • Matthew Slater,
  • Matthew Bartlett,
  • Vasilis Kosmoliaptsis,
  • Regin Lagaac,
  • Anna Sidders,
  • Claire Foley,
  • Valerie Hopkins,
  • Chloe Fitzpatrick-Creamer,
  • Cara Hudson,
  • Sam Turner,
  • Andrew Tambyraja,
  • Sam Dutta,
  • Sarah Lawman,
  • Tracey Salter,
  • Mohammed Aslam,
  • Atul Bagul,
  • Rajesh Sivaprakasam,
  • George Smith,
  • Zia Moinuddin,
  • Simon Knight,
  • Paul Gibbs,
  • Reza Motallebzadeh,
  • Nicholas Barnett,
  • Gavin Pettigrew,
  • Alison Deary,
  • Veena Surendrakumar,
  • Tobi Ayorinde,
  • Igor Chipurovski,
  • Subhankar Paul,
  • Klaus Bond,
  • Elizabeth Hardy,
  • Joanne Widdup,
  • Rachael Potter,
  • Elisabeth Pugh,
  • Karen Parsons,
  • Kathryn Lafferty,
  • Kate Crawford,
  • Amy Bolsworth,
  • Naavalah Ngwa-Ndifor,
  • Rani Badhan,
  • Anna Jerram,
  • Jessica Lai,
  • Joyce Banda,
  • Janet Bendle,
  • Maria Morgan,
  • William Owen,
  • Sue Dawson,
  • Simon Daniel,
  • Karen Allsop,
  • Sarah-Jane Carmichael,
  • Tom Eadie,
  • Rona Lochiel,
  • Midel Lena,
  • Soundrie Padayachee,
  • Philip Eldridge,
  • May Rabuya,
  • Jashree Patel,
  • Abbas Ghazanfar,
  • Judy Van Selm,
  • Caroline Bodneck,
  • Martia Augustin,
  • Kwame Ansu,
  • Nalin Khosla,
  • Kashif Burney,
  • Karen Dear,
  • Carl Tiivas,
  • Maria Truslove,
  • Andrew Beech,
  • Sarah Brand,
  • Darren Cheal,
  • Mel Smith,
  • Kate Trivedi,
  • Adnan Bajwa,
  • John Kerr,
  • Ana Fleet,
  • Lianne Chapman,
  • Sarah Gee,
  • Thanuja Weerasinghe,
  • Paris Cai,
  • Judith Long,
  • Tracey Rowe,
  • Jeremy Crane,
  • Mary Quashie-Akponeware

DOI
https://doi.org/10.1136/bmjopen-2019-031210
Journal volume & issue
Vol. 9, no. 7

Abstract

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Introduction Arteriovenous fistulas (AVFs) are considered the best and safest modality for providing haemodialysis in patients with end-stage renal disease. Only 20% of UK centres achieve the recommended 80% target for achieving dialysis of the prevalent dialysis population via permanent access (as opposed to a central venous catheter). This is partly due to the relatively poor maturation rate of newly created fistulas, with as many as 50% of fistulas failing to mature.The Surveillance Of arterioveNous fistulAe using ultRasound study will examine whether a protocolised programme of Doppler ultrasound (US) surveillance can identify, early after creation, potentially correctable problems in those AVFs that subsequently fail to mature.Methods and analysis This is a multicentre observational study that will assess newly created AVFs by Doppler US performed at 2, 4, 6 and 10 weeks after creation. The primary outcome measure will be primary fistula patency at week 10. Secondary outcome measures include: successful use of the fistula; clinical suitability for dialysis; creation of new fistula or radiological salvage; fistula thrombosis; secondary fistula patency rate and patient acceptability.Ethics and dissemination The study has been approved by the Cambridgeshire and Hertfordshire Research Ethics Committee and by the Health Research Authority (REC 18/EE/0234). The results generated from this work will be published as open access, within 3 years of trial commencement. We will also present our findings at key national/international renal meetings, as well as support volunteers at renal patient groups to disseminate the trial outcome.Trial registration number ISRCTN36033877