SynthesisMedicine2018
Comparison of ultrasound scan blood flow measurement versus other forms of surveillance in the thrombosis rate of hemodialysis access: A systemic review and meta-analysis.
Synthesis in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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.
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Who cites it
4 citing papers in PubMed, 14 citations in OpenAlex.
- Hemodialysis vascular access flow surveillance: Current evidence and future directions.Journal of the Chinese Medical Association : JCMA · 2025Review
- Integrating vascular access surveillance with clinical monitoring for stenosis prediction.Journal of nephrology · 2024Article
- Development and Validation of a Machine Learning Model Predicting Arteriovenous Fistula Failure in a Large Network of Dialysis Clinics.International journal of environmental research and public health · 2021Article
- A Multicenter Randomized Clinical Trial of Hemodialysis Access Blood Flow Surveillance Compared to Standard of Care: The Hemodialysis Access Surveillance Evaluation (HASE) Study.Kidney international reports · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe benefit of access flow surveillance in preventing vascular access thrombosis and failure remains controversial, as many randomized clinical trials (RCTs) have failed to demonstrate consistent results. The aim of this study was to perform a meta-analysis including newly published RCTs with a subgroup analysis for arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs).
methodsA systematic review of the available literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. An electronic search was conducted using the MEDLINE, EMBASE, and Cochrane Library databases of RCTs conducted from 1970 to 2017 that involved access flow surveillance. As a result, 9 RCTs met our criteria. The control group was defined by indirect and various surveillance methods such as dynamic venous pressure measurement and physical examination. Conversely, the interventional group was defined as a noninvasive duplex ultrasound scan (USS) or ultrasound dilution that directly measured the flow of vascular access.
resultsThe studies included 990 patients comprising 658 native AVFs and 332 AVGs. The prevalence of diabetes was 29.3%and 30.5% in the interventional and control groups, respectively. The estimated overall pooled risk ratio (RR) of thrombosis was 0.782 [95% confidence interval (95% CI), 0.553-1.107; P = .17], favoring interventional group, although this was not statistically significant. In the subgroup analysis, the pooled RR of thrombosis was .562 (95% CI, 0.346-0.915; P = .02) for AVFs, which significantly favored the interventional group. Conversely, the pooled RR for AVGs was 1.104 (95% CI, 0.672-1.816; P = .70).
conclusionThe surveillance method to measure access flow through USS showed a significant benefit for reducing thrombosis in AVFs. The result encourages adherence to the current guidelines for AVFs. However, no benefit was found regarding AVGs. Recent guidelines with a "one-size-fits-all" approach may be revised to a "tailored-to-risk" approach.
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