Information needs in vascular access decision-making: A qualitative study of patient and clinical stakeholder perspectives.

Background: The information and decision support needs required to embed a patient-centred strategy are challenging, as several haemodialysis vascular access strategies are possible with significant differences in short- and long-term outcomes of potential treatment options. We aimed to explore and describe stakeholder perspectives on information needs when making decisions about vascular access (VA) for haemodialysis.

Methods: We performed thematic analysis of seven (six online, one in person) focus group discussions including transcripts, post-it phrases and text responses with 14 patients and 12 vascular access professionals (four nephrologists, three surgeons and five nurses - Vascular access nurse specialists/Education and dialysis nurses) who participated in at total of six online and one in person focus group.

Hypertensive load predicts recovery of renal function for patients undergoing revascularisation for renal artery stenosis.

Renal ischaemia due to renal artery stenosis produces two differing responses - a juxtaglomerular hypertensive response and cortical renal dysfunction. The reversibility of renal impairment is not predictable, and thus renal revascularisation is controversial. This study aims to test the hypothesis that the hypertensive response to renal ischaemia reflects viable renal parenchyma, and thus could be used to predict the recovery in renal function.

What are the reported procedural costs of vascular access surgery?

Introduction: Since the inception of arteriovenous grafts (AVG) as a novel technique, there has been greater emphasis on the assessment of outcomes rather than costs. Gross-costing methods over-simplify vascular access surgery and do not reflect the true costs of the service, preventing accurate cost-effectiveness analysis. The aim of this study is to assess the reporting of procedural costs of arteriovenous access creation in economic analyses of vascular access surgery, and to compare the reported costs of the two most performed procedures - arteriovenous fistula (AVF) and arteriovenous graft (AVG).

Quality assurance in surgical trials of arteriovenous grafts for haemodialysis: A systematic review, a narrative exploration and expert recommendations.

Background: Introducing new procedures and challenging established paradigms requires well-designed randomised controlled trials (RCT). However, RCT in surgery present unique challenges with much of treatment tailored to the individual patient circumstances, refined by experience and limited by organisational factors. There has been considerable debate over the outcomes of arteriovenous grafts (AVG) compared to AVF, but any differences may reflect differing practice and potential variability.