. 2019 Jul 23;9(7):e031210.

doi: 10.1136/bmjopen-2019-031210.

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

James Richards^{1

2}, Mohammed Hossain¹, Dominic Summers^{1

2}, Matthew Slater³, Matthew Bartlett⁴, Vasilis Kosmoliaptsis^{1

2}, Edward Cf Wilson⁵, Regin Lagaac⁶, Anna Sidders⁷, Claire Foley⁷, Emma Laing⁷, Valerie Hopkins⁷, Chloe Fitzpatrick-Creamer⁷, Cara Hudson⁷, Helen Thomas⁷, Sam Turner⁸, Andrew Tambyraja⁹, Subash Somalanka¹⁰, James Hunter¹¹, Sam Dutta¹², Sarah Lawman¹³, Tracey Salter^{10

14}, Mohammed Aslam¹⁵, Atul Bagul¹⁶, Rajesh Sivaprakasam¹⁷, George Smith¹⁸, Zia Moinuddin¹⁹, Simon Knight²⁰, Paul Gibbs²¹, Reza Motallebzadeh⁴, Nicholas Barnett²², Gavin Pettigrew^{1

2}; SONAR trial group

Collaborators, Affiliations

Collaborators

SONAR trial group:
Alison Deary, Veena Surendrakumar, Tobi Ayorinde, Igor Chipurovski, Subhankar Paul, Klaus Bond, Elizabeth Hardy, Joanne Widdup, Rachael Potter, Elisabeth Pugh, Karen Parsons, Kathryn Lafferty, Rajesh Sivaprakasam, Kate Crawford, Amy Bolsworth, Naavalah Ngwa-Ndifor, Rani Badhan, Helena Edlin, Anna Jerram, Jessica Lai, Joyce Banda, Janet Bendle, Sam Turner, Maria Morgan, William Owen, Sue Dawson, Simon Daniel, Karen Allsop, Sarah-Jane Carmichael, Tom Eadie, Rona Lochiel, Midel Lena, Soundrie Padayachee, Philip Eldridge, May Rabuya, Jashree Patel, Abbas Ghazanfar, Judy Van Selm, Caroline Bodneck, Martia Augustin, Kwame Ansu, Nalin Khosla, Kashif Burney, Karen Dear, Carl Tiivas, Samantha Hyndman, Maria Truslove, Andrew Beech, Sarah Brand, Darren Cheal, Mel Smith, Kate Trivedi, Adnan Bajwa, John Kerr, Ana Fleet, Lianne Chapman, Sarah Gee, Thanuja Weerasinghe, Paris Cai, Judith Long, Tracey Rowe, Jeremy Crane, Mary Quashie-Akponeware

Affiliations

¹ Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
² Department of Surgery, Cambridge University, Cambridge, UK.
³ Vascular Studies Unit, Addenbrooke's Hospital, Cambridge, UK.
⁴ Department of Nephrology and Renal Transplantation, Royal Free London NHS Foundation Trust, London, UK.
⁵ Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK.
⁶ Cambridge Dialysis Centre, Cambridge University Hospitals, Cambridge.
⁷ Clinical trials Unit, NHS Blood and Transplant, Cambridge, UK.
⁸ Renal and Transplant, North Bristol NHS Trust, Westbury on Trym, UK.
⁹ Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
¹⁰ Department of Nephrology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.
¹¹ Renal transplantation and nephrology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
¹² Nottingham Renal and Kidney Transplant Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
¹³ Sussex Kidney Unit, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
¹⁴ Nephrology Department, Frimley Health NHS Foundation Trust, Frimley, UK.
¹⁵ Department of Vascular Surgery, Imperial College London Department of Surgery and Cancer, London, UK.
¹⁶ Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK.
¹⁷ Department of Surgery, Barts Health NHS Trust, London, UK.
¹⁸ Hull York Medical School, Hull University Teaching Hospitals NHS Trust, Hull, UK.
¹⁹ Renal Transplant Unit, Manchester University NHS Foundation Trust, Manchester, UK.
²⁰ Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
²¹ Renal Transplant Department, Portsmouth Hospitals NHS Trust, Portsmouth Hospitals NHS Trust, Portsmouth, UK.
²² Transplant Unit, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.

PMID: 31340975
PMCID: PMC6661628
DOI: 10.1136/bmjopen-2019-031210

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

James Richards et al. BMJ Open. 2019.

. 2019 Jul 23;9(7):e031210.

doi: 10.1136/bmjopen-2019-031210.

Authors

Collaborators

SONAR trial group:
Alison Deary, Veena Surendrakumar, Tobi Ayorinde, Igor Chipurovski, Subhankar Paul, Klaus Bond, Elizabeth Hardy, Joanne Widdup, Rachael Potter, Elisabeth Pugh, Karen Parsons, Kathryn Lafferty, Rajesh Sivaprakasam, Kate Crawford, Amy Bolsworth, Naavalah Ngwa-Ndifor, Rani Badhan, Helena Edlin, Anna Jerram, Jessica Lai, Joyce Banda, Janet Bendle, Sam Turner, Maria Morgan, William Owen, Sue Dawson, Simon Daniel, Karen Allsop, Sarah-Jane Carmichael, Tom Eadie, Rona Lochiel, Midel Lena, Soundrie Padayachee, Philip Eldridge, May Rabuya, Jashree Patel, Abbas Ghazanfar, Judy Van Selm, Caroline Bodneck, Martia Augustin, Kwame Ansu, Nalin Khosla, Kashif Burney, Karen Dear, Carl Tiivas, Samantha Hyndman, Maria Truslove, Andrew Beech, Sarah Brand, Darren Cheal, Mel Smith, Kate Trivedi, Adnan Bajwa, John Kerr, Ana Fleet, Lianne Chapman, Sarah Gee, Thanuja Weerasinghe, Paris Cai, Judith Long, Tracey Rowe, Jeremy Crane, Mary Quashie-Akponeware

Affiliations

¹ Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
² Department of Surgery, Cambridge University, Cambridge, UK.
³ Vascular Studies Unit, Addenbrooke's Hospital, Cambridge, UK.
⁴ Department of Nephrology and Renal Transplantation, Royal Free London NHS Foundation Trust, London, UK.
⁵ Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK.
⁶ Cambridge Dialysis Centre, Cambridge University Hospitals, Cambridge.
⁷ Clinical trials Unit, NHS Blood and Transplant, Cambridge, UK.
⁸ Renal and Transplant, North Bristol NHS Trust, Westbury on Trym, UK.
⁹ Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
¹⁰ Department of Nephrology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.
¹¹ Renal transplantation and nephrology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
¹² Nottingham Renal and Kidney Transplant Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
¹³ Sussex Kidney Unit, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
¹⁴ Nephrology Department, Frimley Health NHS Foundation Trust, Frimley, UK.
¹⁵ Department of Vascular Surgery, Imperial College London Department of Surgery and Cancer, London, UK.
¹⁶ Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK.
¹⁷ Department of Surgery, Barts Health NHS Trust, London, UK.
¹⁸ Hull York Medical School, Hull University Teaching Hospitals NHS Trust, Hull, UK.
¹⁹ Renal Transplant Unit, Manchester University NHS Foundation Trust, Manchester, UK.
²⁰ Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
²¹ Renal Transplant Department, Portsmouth Hospitals NHS Trust, Portsmouth Hospitals NHS Trust, Portsmouth, UK.
²² Transplant Unit, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.

PMID: 31340975
PMCID: PMC6661628
DOI: 10.1136/bmjopen-2019-031210

Abstract

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.

Keywords: dialysis; end stage renal failure; surgery; ultrasound.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
SONAR study flow chart flow chart of patient journey from screening and enrolment through to final study scan and clinical assessment within the SONAR trial. AVF, arteriovenous fistula; SONAR, Surveillance Of arterioveNous fistulAe using ultRasound.

See this image and copyright information in PMC

References

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

Collaborators

Affiliations

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

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

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References

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