Trial reportJournal of the American Society of Nephrology : JASN2013
Risk of vascular access complications with frequent hemodialysis.
Trial report in Journal of the American Society of Nephrology : JASN, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03239808 (Assessment of the Incremental Haemodialysis Security and Effectiveness in Incident Patients), which is not on this map. Cited by 49 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Assessment of the Incremental Haemodialysis Security and Effectiveness in Incident Patients
Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Home versus in-centre haemodialysis for people with kidney failure.The Cochrane database of systematic reviews · 2024Pooled it
- Interventions for fatigue in people with kidney failure requiring dialysis.The Cochrane database of systematic reviews · 2023Pooled it
- Home versus in-centre haemodialysis for end-stage kidney disease.The Cochrane database of systematic reviews · 2014Pooled it
- A Trial of Extending Hemodialysis Hours and Quality of Life.Journal of the American Society of Nephrology : JASN · 2017Trial
- Illness Beliefs in End Stage Renal Disease and Associations with Self-Care Modality Choice.PloS one · 2016Trial
- Long-term Effects of Frequent Nocturnal Hemodialysis on Mortality: The Frequent Hemodialysis Network (FHN) Nocturnal Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2015Trial
- Survey of home hemodialysis patients and nursing staff regarding vascular access use and care.Hemodialysis international. International Symposium on Home Hemodialysis · 2015Trial
- Effects of frequent hemodialysis on perceived caregiver burden in the Frequent Hemodialysis Network trials.Clinical journal of the American Society of Nephrology : CJASN · 2014Trial
- Comparing outcomes with different dialysis modalities in children with kidney failure: home hemodialysis versus in-center hemodiafiltration or conventional hemodialysis.Pediatric nephrology (Berlin, Germany) · 2026Article
- Perspectives on Quality of Life, Vascular Access, and Fluid Balance in Incremental Hemodialysis: A Narrative Review.Kidney360 · 2026Review
- Implementing a Protocol for Incremental Hemodialysis in Incident Patients With Kidney Failure: A Quality Improvement Initiative.Canadian journal of kidney health and disease · 2026Article
- Patency and effectiveness of vascular access for hemodialysis patients: a descriptive study.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2025Article
- Optimizing dialysis modalities for diabetic end-stage kidney disease: A focus on personalized care and resource-limited settings.World journal of diabetes · 2025Article
- Article
- Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study.Renal failure · 2024Observational
- The Impact of the Dialysis Event Prevention Bundle on the Reduction in Dialysis Event Rate in Patients with Catheters: A Retrospective and Prospective Cohort Study.Diseases (Basel, Switzerland) · 2024Article
- Article
- Incremental hemodialysis and vascular access complications: a 12-year experience in a hospital hemodialysis unit.Journal of nephrology · 2024Article
- Medical Distrust Among Kidney Transplant Candidates.Clinical transplantation · 2024Article
- Long-term survival of patients receiving home hemodialysis with self-punctured arteriovenous access.PloS one · 2024Observational
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
Frequent hemodialysis requires using the vascular access more often than with conventional hemodialysis, but whether this increases the risk for access-related complications is unknown. In two separate trials, we randomly assigned 245 patients to receive in-center daily hemodialysis (6 days per week) or conventional hemodialysis (3 days per week) and 87 patients to receive home nocturnal hemodialysis (6 nights per week) or conventional hemodialysis, for 12 months. The primary vascular access outcome was time to first access event (repair, loss, or access-related hospitalization). Secondary outcomes were time to all repairs and time to all losses. In the Daily Trial, 77 (31%) of 245 patients had a primary outcome event: 33 repairs and 15 losses in the daily group and 17 repairs, 11 losses, and 1 hospitalization in the conventional group. Overall, the risk for a first access event was 76% higher with daily hemodialysis than with conventional hemodialysis (hazard ratio [HR], 1.76; 95% confidence interval [CI], 1.11-2.79; P=0.017); among the 198 patients with an arteriovenous (AV) access at randomization, the risk was 90% higher with daily hemodialysis (HR, 1.90; 95% CI, 1.11-3.25; P=0.02). Daily hemodialysis patients had significantly more total AV access repairs than conventional hemodialysis patients (P=0.011), with 55% of all repairs involving thrombectomy or surgical revision. Losses of AV access did not differ between groups (P=0.58). We observed similar trends in the Nocturnal Trial, although the results were not statistically significant. In conclusion, frequent hemodialysis increases the risk of vascular access complications. The nature of the AV access repairs suggests that this risk likely results from increased hemodialysis frequency rather than heightened surveillance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.