Fistula versus graft for hemodialysis access in older adults
A Randomized Trial of Fistula vs. Graft Arteriovenous Vascular Access in Older Adults with End-Stage Kidney Disease on Hemodialysis: The AV ACCESS Trial
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 ID | NIH-11178427 on NIH RePORTER |
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.
Who could benefit from this research
Good fit: 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.
Not a fit: 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.
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 performed: 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
Winston-Salem, United States
- Wake Forest University Health Sciences — Winston-Salem, United States (Active)
Researchers
- Principal investigator: Murea, Mariana — Wake Forest University Health Sciences
- Study coordinator: Murea, Mariana
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 below.