Evidence map›Paper›PMID 39832484›Full record

ArticleNephron2025

Prospective Evaluation of Remote Software Based Surveillance Supplementing Clinical Monitoring for Haemodialysis Vascular Access.

Alshymaa Rafiek Eltahan, Zulfikar Pondor, Rosemary L Donne, David Lewis, Maharajan Raman, Jan Cowperthwaite, Marinela Liliana Resiga, Paul Hinchliffe, Jazzle Lim, Paula Gleave and 2 more

Abstract read
In one paragraph

Article in Nephron, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Alshymaa Rafiek EltahanInternal Medicine and Nephrology Department, Faculty of Medicine, Helwan University, Cairo, Egypt, alshymaaeltahan@gmail.com.
Zulfikar PondorRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Rosemary L DonneRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
David LewisRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Maharajan RamanRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Jan CowperthwaiteRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Marinela Liliana ResigaRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Paul HinchliffeRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Jazzle LimRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Paula GleaveRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Jonathan AllsoppFinance Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.
Dimitrios PoulikakosRenal Department, Northern Care Alliance NHS Foundation Trust, Salford Care Organization, Greater Manchester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEfficient arteriovenous vascular access (VA) surveillance is vital for early identification of dysfunctional access, allowing timely intervention to prevent thrombosis. This study compares the efficacy of adding remote software surveillance to standard clinical care across our units.

methodsWe conducted a 12-month prospective study on maintenance haemodialysis (HD) patients using Vasc-Alert software technology to assist clinical decision-making in 2 satellite HD units (group 1) and standard care in the remaining 3 HD units (group 2). Patients with Vasc-Alert-derived high Access Risk Score (ARS) (≥7) underwent clinical assessment and were referred for fistulogram based on relevant Kidney Disease Outcome Quality Initiative (KDOQI) criteria. Data on referrals for fistulogram, subsequent VA events, access abandonment, and complication-free days-extended (CFD-extended) were collected. VA survival analysis of post-intervention primary patency rate at 3 and 6 months was conducted.

resultsThere were 23 (28.1%) pre-emptive correction of stenosis and 6 (7.3%) thrombosis episodes in group 1, compared to 40 (19.5%) and 21 (10.2%) in group 2 (p value 0.155, 0.587), respectively). Among the thrombotic episodes, 83% of cases in group 1 had been detected during surveillance and referred for diagnostic fistulogram ± angioplasty but developed thrombosis while awaiting elective intervention compared to 19% in group 2 (p = 0.004). Median time from fistulogram request to thrombosed VA was 26 days (interquartile range: 21-42 days). Group 1 exhibited better post-intervention primary patency rates and longer CFD compared to group 2 (p value <0.001, 0.002, respectively).

conclusionIncorporating Vasc-Alert technology into VA clinical surveillance pathway was associated with improved early detection of high-risk VA, higher primary patency rates, and longer CFD-extended compared to standard of care. Improving elective interventional radiology capacity for timely intervention (<3 weeks from referral) is crucial to materialise the benefits of enhanced surveillance in preventing acute thrombosis.

Indexed as

Arteriovenous Shunt, SurgicalRenal DialysisSoftwareAgedFemaleHumansMaleMiddle AgedMonitoring, PhysiologicProspective StudiesThrombosisVascular PatencyHaemodialysisPre-emptive stenosis correctionSurveillanceVasc-Alert technologyVascular access

Identifiers

PMID39832484
PMCPMC12136521

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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.