Hemodialysis Vascular Access Roundtable

Event Details

Background

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.

Registration Deadline

July 14, 2016

Agenda

July 18, 2015

7:30 a.m. – 8:00 a.m.

Registration

8:00 a.m. – 8:10 a.m.

Welcome from NIDDK
Robert Star

8:10 a.m. – 8:20 a.m.

Overview of the roundtable
Michael Allon

Initial presentation of research proposals

8:20 a.m. – 8:30 a.m.

Presentation 1: Leveraging healthcare provider organizations, large dialysis organization and vascular access centers to develop a pragmatic, precision medicine approach to dialysis vascular access care
Prabir Roy-Chaudhury

8:30 a.m. – 8:50 a.m.

Discussion of presentation 1

8:50 a.m. – 9:00 a.m.

Presentation 2: RCT of early vs late AVF surgery in pre-dialysis patients
Allen Nissensen

9:00 a.m. – 9:20 a.m.

Discussion of presentation 2

9:20 a.m. – 9:30 a.m.

Presentation 3: RCT of AVF vs AVG surgery in high risk patients starting HD with a CVC
Michael Allon

9:30 a.m. – 9:50 a.m.

Discussion of presentation 3

9:50 a.m. – 10:10 a.m.

Break

10:10 a.m. – 10:20 a.m.

Presentation 4: Prospective evaluation of interventional strategies to salvaging non-maturing AVFs
Scott Berceli

10:20 a.m. – 10:40 a.m.

Discussion of presentation 4

10:40 a.m. – 11:10 a.m.

Open Forum: Other research ideas

11:10 a.m. – 12:00 p.m.

Expanded discussion of presentation 1

12:00 p.m. – 1:00 p.m.

Lunch

1:00 p.m. – 1:50 p.m.

Expanded discussion of presentation 2

1:50 p.m. – 2:40 p.m.

Expanded discussion of presentation 3

2:40 p.m. – 2:50 p.m.

Break

2:50 p.m. – 3:40 p.m.

Expanded discussion of presentation 4

3:40 p.m. – 3:50 p.m.

Summary of discussion
Michael Allon

3:50 p.m. – 4:00 p.m.

Next steps
Robert Star