Fistula versus graft for hemodialysis access in older adults
Official title: A Randomized Trial of Fistula vs. Graft Arteriovenous Vascular Access in Older Adults with End-Stage Kidney Disease on Hemodialysis: The AV ACCESS Trial
Funded at Wake Forest University Health Sciences · NIH-11178427 · Data updated 2026-11-12
This study compares two types of surgical dialysis access—fistulas and grafts—to find which is better for adults aged 65 and older who are using a catheter for hemodialysis.
Quick facts
| Grant type | R01 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Wake Forest University Health Sciences NIH-funded |
| Lab location | 1 site (Winston-Salem, United States) |
| Project start | September 1, 2021 |
| Project end | August 31, 2026 |
| Funding year | 2025 |
| Award (this year) | $828,855 |
| NIH project number | 5R01AG071803-05 |
| Project ID | NIH-11178427 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults aged 65 or older who are receiving hemodialysis via a central venous catheter and are candidates for surgical creation of either an arteriovenous fistula or graft.
✕Less likely to help
People under 65, those not on hemodialysis, those who already have a functioning fistula or graft, or those who are not surgical candidates are unlikely to benefit from participation.
What this research studies
If you are 65 or older and receiving hemodialysis through a catheter, you may be randomly assigned to get either an arteriovenous fistula or a graft placed surgically. The trial is being carried out at multiple medical centers and follows participants to track infections, vascular complications, need for additional procedures, and patients' experiences. This builds on a small pilot that showed randomizing older adults to fistula versus graft is feasible and aims to enroll about 262 people to provide clearer guidance. Your regular dialysis care continues while the study team collects medical outcomes and quality-of-life information over time.
Why it matters
Potential benefit: If successful, the results could show which access type lowers infections and complications and leads to better dialysis outcomes for older adults.
How similar studies have gone: A prior small pilot trial and observational studies suggested grafts may perform better in older adults, but this is the first adequately powered randomized trial to provide definitive evidence.
Where this research is happening
-
Wake Forest University Health Sciences
Winston-Salem, United States Active
Researchers
- Principal investigator: Murea, Mariana — Wake Forest University Health Sciences
- Study coordinator: Murea, Mariana
Related research
Other NIH-funded projects on the same topics.
-
Using at-home neurostimulation to reduce pain in patients with end-stage kidney disease on dialysis
This study is looking at a new way to help people with end-stage kidney disease manage their pain at home during hemodialysis using a gentle electrical stimulation method, which could reduce the need for strong pain medications.
-
Comparing two types of vascular access for older adults on hemodialysis
This study is looking at how well two types of surgeries for getting blood access work for older adults with severe kidney disease who need dialysis, to see which one helps them feel better and be happier with their treatment.
-
How dialysis facility growth affects care for people with end-stage kidney disease
New research will examine whether the spread of dialysis centers and new treatment technologies benefit patients with end-stage kidney disease, and whether benefits reach all communities.
-
Hospital-to-SNF Transitions for Kidney Failure Patients
Aimed at improving how patients with end-stage kidney disease move from hospital to skilled nursing facilities to reduce readmissions.
-
Medically tailored meals for children with kidney failure
A study compares different ways to give tailored meals to kids with end-stage kidney disease to see what works best for families and health.
-
Telehealth for rural patients with end-stage kidney disease
A doctor-researcher at a major university is studying how telehealth can help people with advanced kidney disease in rural areas access care and stay on track for transplantation.
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.