Acoustic Analysis of VA Sounds

NCT ID: NCT05612022

Last Updated: 2024-11-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

44 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-05-09

Study Completion Date

2026-12-31

Brief Summary

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End-stage renal disease (ESRD) is a growing global health problem, strictly connected with progressive ageing population and longer survival of patients living on renal replacement therapy. The majority of ESRD patients is on hemodialysis (HD) treatment. A successful HD procedure requires a functioning vascular access (VA) to provide safe and long-lasting way to connect patient circulation to the artificial kidney. The current recommendation for VA is the native arteriovenous fistula (AVF), surgically created in the forearm by an anastomosis between a vein and an artery. The AVF, despite being the first-choice treatment, is still affected by high non-maturation and early failure rates, requiring in most of the cases, the creation of a new VA. An arteriovenous graft (AVG) is the second choice for a VA. Surgery is done using an artificial plastic tube that connects an artery to a vein. The AVG matures earlier than AVF (2/3 vs 6 weeks), but it is more prone to infections and has lower survival.

It would be important to identify patients at risk of VA failure, but there is currently a lack of adequate strategies for surveillance. A continuous monitoring of the VA function would help in identification of reduced blood flow and VA stenosis, that could be treated by interventional radiologists before AVF or AVG complete closure. Over the years, nurses and nephrologists got used to touch the VA and qualitatively evaluate its vibration, named "thrill", and the sounds emitted by the same using their stethoscope.

The purpose of this study is to assess the feasibility of VA sound recording and analysis and provide preliminary evidence of VA sound clinical validity and utility to assess, monitor and predict vascular remodelling occurring in AVFs and AVGs.

This is a single center prospective observational study involving the acquisition of VA sounds and Doppler US examinations in consenting patients with ESRD.

To reach this goal, two groups of ESRD patients in need of VA surgery to perform HD treatment will be involved:

Group 1. Patients with AVF as first line HD access option.

Group 2. Patients with AVG as first line HD access option.

Detailed Description

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Conditions

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End Stage Renal Disease Hemodialysis Access Failure

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Group 1. Patients with AVF as first line HD access option.

24 consecutive patients in need of AVF enrolled at the Nephrology and Dialysis unit of the ASST-Papa Giovanni XXIII of Bergamo.

AVF creation

Intervention Type PROCEDURE

AVF is surgically created in the forearm by an anastomosis between a vein and an artery

Group 2. Patients with AVG as first line HD access option.

20 consecutive patients in need of AVG enrolled at the Nephrology and Dialysis unit of the ASST-Papa Giovanni XXIII of Bergamo.

AVG creation

Intervention Type PROCEDURE

Surgery is done using an artificial plastic tube that connects an artery to a vein

Interventions

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AVF creation

AVF is surgically created in the forearm by an anastomosis between a vein and an artery

Intervention Type PROCEDURE

AVG creation

Surgery is done using an artificial plastic tube that connects an artery to a vein

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Provision of informed consent prior to any study specific procedures.
2. Patients in HD treatment that need a new VA or patients that entered the pre-dialysis program because of ESRD. In all these cases the treatment of first choice should be the creation of a distal autogenous AVF, the creation of an AVG or the proximalization of an occluded VA.

Exclusion Criteria

1. Contraindications for the creation of an autogenous AVF, for the AVG creation or the proximalization of a failed VA.
2. Patients who use catheter to perform HD.
3. Patients undergoing peritoneal dialysis.
4. Patients with life expectancy less than 2 years.
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mario Negri Institute for Pharmacological Research

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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ASST HPG23 Unità di Nefrologia e Dialisi

Bergamo, BG, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Anna Caroli

Role: CONTACT

003903545351

Sofia Poloni

Role: CONTACT

003903545351

Facility Contacts

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Carmela Giuseppina Condemi, MD

Role: primary

0039 035 2673992

Patrizia Ondei, MD

Role: backup

Other Identifiers

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VAsound

Identifier Type: -

Identifier Source: org_study_id