Surveillance arterioveNous fistulAs using ultRasound (SONAR) trial in haemodialysis patients: A study protocol for a multicentre observational study

James Richards, Mohammed Hossain, Dominic Summers, Matthew Slater, Matthew Bartlett, Vasilis Kosmoliaptsis, Edward C.F. Wilson, Regin Lagaac, Anna Sidders, Claire Foley, Emma Laing, Valerie Hopkins, Chloe Fitzpatrick-Creamer, Cara Hudson, Helen Thomas, Sam Turner, Andrew Tambyraja, Subash Somalanka, James Hunter, Sam DuttaSarah Lawman, Tracey Salter, Mohammed Aslam, Atul Bagul, Rajesh Sivaprakasam, George Smith, Zia Moinuddin, Simon Knight, Paul Gibbs, Reza Motallebzadeh, Nicholas Barnett, Gavin Pettigrew

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Introduction Arteriovenous fistulas (AVFs) are considered the best and safest modality for providing haemodialysis in patients with end-stage renal disease. Only 20% of UK centres achieve the recommended 80% target for achieving dialysis of the prevalent dialysis population via permanent access (as opposed to a central venous catheter). This is partly due to the relatively poor maturation rate of newly created fistulas, with as many as 50% of fistulas failing to mature. The Surveillance Of arterioveNous fistulAe using ultRasound study will examine whether a protocolised programme of Doppler ultrasound (US) surveillance can identify, early after creation, potentially correctable problems in those AVFs that subsequently fail to mature. Methods and analysis This is a multicentre observational study that will assess newly created AVFs by Doppler US performed at 2, 4, 6 and 10 weeks after creation. The primary outcome measure will be primary fistula patency at week 10. Secondary outcome measures include: successful use of the fistula; clinical suitability for dialysis; creation of new fistula or radiological salvage; fistula thrombosis; secondary fistula patency rate and patient acceptability. Ethics and dissemination The study has been approved by the Cambridgeshire and Hertfordshire Research Ethics Committee and by the Health Research Authority (REC 18/EE/0234). The results generated from this work will be published as open access, within 3 years of trial commencement. We will also present our findings at key national/international renal meetings, as well as support volunteers at renal patient groups to disseminate the trial outcome. Trial registration number ISRCTN36033877

Original languageEnglish
Article numbere031210
Number of pages7
JournalBMJ Open
Issue number7
Early online date23 Jul 2019
Publication statusPublished - 23 Jul 2019


  • dialysis
  • end stage renal failure
  • surgery
  • ultrasound

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