Vascular access is required for all patients with end-stage renal disease (ESRD) who undergo maintenance hemodialysis. Patients who start dialysis with a catheter accrue in excess of $40,000 more in annual costs, compared with patients who start dialysis with a fistula. Importantly, it has been well documented that catheter use for hemodialysis is associated with a higher risk of complications, including serious and life threatening infections, compared to other more permanent forms of access including fistulas or grafts. Although fistulas are the recommended type of vascular access in many patients currently the overwhelming majority of patients in the U.S. start hemodialysis with catheters, placing them at high and avoidable risk for adverse outcomes. Although fistulas are often the preferred type of vascular access, they often do not mature to be used for regular hemodialysis.
In September 2015 the NIDDK held a workshop on hemodialysis vascular access (Hemodialysis Vascular Access: Taking the Next Steps) to identify future directions in clinical and basic research. To continue the process of identifying clinically important research to improve hemodialysis vascular access in the U.S. hemodialysis patient population the Institute will hold a second meeting, A Roundtable on Clinical Research for Hemodialysis Vascular Access, in the summer of 2016. Selected participants of the roundtable will be asked to present their two most important (highest priority) clinical research studies to move the field forward. The proposed studies will be discussed in depth by all attendees, and at the end of the meeting a prioritized list will be established. Participants of this meeting will include clinical researchers, leaders of large dialysis organizations and representatives from the Centers for Medicare & Medicaid Services, the Patient Centered Outcomes Research Institute, Agency for Healthcare Research & Quality, Department of Veterans Affairs, the Food and Drug Administration, professional societies for kidney disease and advocacy groups for patients with chronic kidney disease, among others.
July 14, 2016