Evidence map›Paper›PMID 30659057›Full record

Trial reportClinical journal of the American Society of Nephrology : CJASN2019

Buttonhole versus Stepladder Cannulation for Home Hemodialysis: A Multicenter, Randomized, Pilot Trial.

Shih-Han S Huang, Jennifer MacRae, Dana Ross, Rameez Imtiaz, Brittany Hollingsworth, Gihad E Nesrallah, Michael A Copland, Philip A McFarlane, Christopher T Chan, Deborah Zimmerman

Open access · greenAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical journal of the American Society of Nephrology : CJASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Guideline
  2. Review
  3. Article
  4. Article
  5. Kidney medicine
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 9 institutions in 2 countries.

Shih-Han S HuangDepartment of Medicine, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.
Jennifer MacRaeDepartment of Medicine, Division of Nephrology, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada.
Dana RossOttawa Hospital, Ottawa, Ontario, Canada.
Rameez ImtiazUniversity of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
Brittany HollingsworthKidney Research Centre of the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Gihad E NesrallahFaculty of Medicine, Division of Nephrology, Humber River Hospital, Toronto, Ontario, Canada.
Michael A CoplandDepartment of Medicine, Division of Nephrology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; and.
Philip A McFarlaneSt. Michael's Hospital, and.
Christopher T ChanDepartment of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Deborah ZimmermanOttawa Hospital, Ottawa, Ontario, Canada.
Ottawa Hospital Research InstituteHumber River Regional Hospital · CAOttawa Hospital · CASt Michael’s Hospital · IEUniversity Health Network · CAUniversity of British Columbia · CAUniversity of Calgary · CAUniversity of Ottawa · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesCanadian home hemodialysis guidelines highlight the potential differences in complications associated with arteriovenous fistula (AVF) cannulation technique as a research priority. Our primary objective was to determine the feasibility of randomizing patients with ESKD training for home hemodialysis to buttonhole versus stepladder cannulation of the AVF. Secondary objectives included training time, pain with needling, complications, and cost by cannulation technique. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: All patients training for home hemodialysis at seven Canadian hospitals were assessed for eligibility, and demographic information and access type was collected on everyone. Patients who consented to participate were randomized to buttonhole or stepladder cannulation technique. Time to train for home hemodialysis, pain scores on cannulation, and complications over 12 months was recorded. For eligible but not randomized patients, reasons for not participating in the trial were documented.

resultsPatient recruitment was November 2013 to November 2015. During this time, 158 patients began training for home hemodialysis, and 108 were ineligible for the trial. Diabetes mellitus as a cause of ESKD (31% versus 12%) and central venous catheter use (74% versus 6%) were more common in ineligible patients. Of the 50 eligible patients, 14 patients from four out of seven sites consented to participate in the study (28%). The most common reason for declining to participate was a strong preference for a particular cannulation technique (33%). Patients randomized to buttonhole versus stepladder cannulation required a shorter time to complete home hemodialysis training. We did not observe a reduction in cannulation pain or complications with the buttonhole method. Data linkages for a formal cost analysis were not conducted.

conclusionsWe were unable to demonstrate the feasibility of conducting a randomized, controlled trial of buttonhole versus stepladder cannulation in Canada with a sufficient number of patients on home hemodialysis to be able to draw meaningful conclusions.

Indexed as

Arteriovenous Shunt, SurgicalHemodialysis, HomeAdultAgedCanadaCatheterizationCost-Benefit AnalysisFemaleHealth Care CostsHumansKidney Failure, ChronicMaleMiddle AgedPilot ProjectsTime FactorsTreatment Outcomearteriovenous fistulaButtonholeCannulationCatheterizationCentral Venous CathetersDemographydiabetes mellitusHemodialysishemodialysis accessHomeInformation Storage and RetrievalKidney Failure, ChronicPainPatient SelectionPilot Projectsrandomized controlled trialsStep-Ladder

Identifiers

PMID30659057
PMCPMC6419275
OpenAlexW2910073126

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.