Arteriovenous Fistula Clinical Trial
Official title:
A Cohort Study of the Histopathological Changes Evident in Vein Wall at the Time of Arteriovenous Dialysis Access Fistulas and the Effects of Such Changes on Biomechanical Compliance and Patient's Clinical Outcomes in a University Teaching Hospital.
Patients whose kidneys have failed need to receive dialysis treatment, most commonly with a
dialysis machine. In order to be connected to the machine an operation is often performed to
join an artery to a vein in the arm. This forms what is known as an arteriovenous fistula.
The fistula causes an increase in the flow of blood through the vein and the vein reacts to
this by becoming bigger and thicker, making it easier to connect the patient to the machine.
The success rate for the operation is relatively low and only approximately 65 from every 100
operations is still working after a year. It is thought that one factor that may cause
problems with the fistula is the ability of the vein to stretch in response to increased
blood flow. Previous research has shown that veins in kidney failure patients look different
to those of people whose kidneys are working when viewed under a microscope.
The investigators aim to study the structure of the vein that is used in making fistulas with
a microscope and also to test it in an engineering laboratory to see how much it will
stretch. The investigators hope that gaining information about the structure of the vein and
its ability to stretch will help determine what it is about the vein that affects how well it
works as part of a fistula. This information may help surgeons select the best possible vein
in a given patient to give the best chance of a working fistula in the future.
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