SynthesisThe journal of vascular access2026
A meta-analysis of the hemodynamic and echocardiographic changes following arteriovenous fistula ligation in chronic kidney disease patients.
Synthesis in The journal of vascular access, 2026. 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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Abstract
Arteriovenous fistulas (AVFs) are the preferred method for establishing long-term vascular access in patients undergoing hemodialysis; however, high-flow AVFs may increase cardiovascular strain after kidney transplantation, often necessitating fistula closure. Currently, no established guideline exists for managing high-flow fistulas in post-transplant patients with stable kidney function, and available studies report heterogeneous results with small sample sizes and different methodologies. We performed a systematic search of PubMed, Cochrane, and Embase up to December 2024 for observational studies and randomized controlled trials comparing AVF ligation versus maintenance in patients with end-stage kidney disease. The meta-analysis was conducted using Cochrane's RevMan software using mean difference (MD) and 95% confidence interval. Twelve studies including 844 patients were analyzed, of whom 409 (48%) underwent AVF ligation, with follow-up ranging from 3 to 62.5 months. AVF ligation was associated with a significant reduction in left ventricular mass index (MD -10.92 g/m
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