SynthesisBMC nephrology2025
A change of heart: the effect of high flow arteriovenous fistulas on cardiovascular outcomes - a systematic review and synthesis without meta-analysis (SWiM).
Synthesis in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A meta-analysis of the hemodynamic and echocardiographic changes following arteriovenous fistula ligation in chronic kidney disease patients.The journal of vascular access · 2026Pooled it
- New-Onset Heart Failure in Hemodialysis Patients: Association With Access Location and Access Flow in a Nationwide Cohort From Sweden.Kidney medicine · 2026Article
- A Vein Attempt? Experimental Models for Arteriovenous Fistula Research.Cardiovascular engineering and technology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and hypothesisAlthough arteriovenous fistulas (AVF) are widely accepted as the gold standard form of dialysis access for haemodialysis patients, high AVF flow may impose significant haemodynamic stress, potentially contributing to adverse cardiovascular events, including heart failure (HF). We hypothesize that higher AVF flow is associated with adverse cardiovascular outcomes including an increased incidence of heart failure. We sought to clarify this relationship as understanding this association is crucial for improving patient care.
methodsA comprehensive search of the PubMed, EMBASE, and Cochrane databases was used to identify observational studies and randomized controlled trials reporting an effect of AVF flow on cardiac outcomes (clinical, echocardiographic, and biomarker). Due to study heterogeneity, meta-analysis was not feasible. Synthesis without meta-analysis (SWiM) was performed using vote counting of direction of effect as the primary outcome.
resultsHigher AVF flow rates were consistently associated with increased incidence of HF and worsening HF symptoms. Cardiac imaging revealed left ventricular dilation and reduced left ventricular ejection fraction in patients with high-flow AVFs. Elevated biomarkers, such as natriuretic peptides, corroborated the adverse cardiovascular effects of high AVF flow.
conclusionsThis systematic review and synthesis without meta-analysis showed a positive relationship between AVF flow and clinical, echocardiographic, and biomarker cardiovascular outcomes. The methodological heterogeneity of studies highlights the need for well-designed prospective research with standardised definitions of high flow AVFs and measures for reporting of cardiovascular outcomes.
Indexed as
Identifiers
What OpenQuestion holds
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.