Apixaban After Dialysis Access Surgery in People With End-Stage Kidney Disease
Tests apixaban to help arteriovenous fistulas mature in adults with end-stage renal disease.
Plain-language title generated from the registry record
Registry title: Effect of Apiban Therapy on AVF Maturation in ESRD Patients
Key facts
- Where
- Lahore, PakistanSee the site
Where in Pakistan
- Combined Military Hospital, LahoreLahore, PakistanTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Combined military hospital lahore
- Trial code
- NCT07559942
- Record updated
- 7 May 2026
- Original description
End-stage renal disease (ESRD) is a growing global health burden, and the creation of a native arteriovenous fistula (AVF) is the gold standard for vascular access in patients requiring hemodialysis [1]. AVFs offer superior longevity, fewer infectious complications, and lower mortality rates compared to central venous catheters or synthetic grafts [2]. However, a significant limitation to their widespread success is the high rate of early failure, primarily due to failure to mature (FTM). FTM occurs in 20-40% of AVFs, rendering them unusable for dialysis [3].Read full original descriptionShow less
"Effect of Perioperative and Short-Term Apixaban Therapy on Arteriovenous Fistula Maturation in Patients With End-Stage Renal Disease: A Randomized Controlled Trial"
End-stage renal disease (ESRD) is a growing global health burden, and the creation of a native arteriovenous fistula (AVF) is the gold standard for vascular access in patients requiring hemodialysis [1]. AVFs offer superior longevity, fewer infectious complications, and lower mortality rates compared to central venous catheters or synthetic grafts [2]. However, a significant limitation to their widespread success is the high rate of early failure, primarily due to failure to mature (FTM). FTM occurs in 20-40% of AVFs, rendering them unusable for dialysis [3].
Apixaban, a direct factor Xa inhibitor, offers a potential advantage by providing sustained anticoagulation throughout the critical maturation period [7]. Its predictable pharmacokinetics, oral administration, and favorable safety profile make it an attractive agent for short-term use in this setting [8]. By reducing microthrombotic events during the first 4-6 weeks following AVF creation, apixaban could potentially improve maturation rates. However, this potential benefit must be weighed against the increased risk of bleeding, hematoma formation, and wound complications that could negatively impact fistula maturation [9].
Inclusion: Age ≥ 18 years; Diagnosis of ESRD (eGFR < 15 mL/min/1.73m² or already on dialysis) with plans for hemodialysis; Planned primary upper extremity AVF creation (radiocephalic, brachiocephalic, or brachiobasilic); Suitable vessels on preoperative duplex ultrasound (artery ≥ 2 mm, vein ≥ 2.5 mm without tourniquet); Ability to provide informed consent.
Exclusion: Current dual antiplatelet therapy; Known bleeding diathesis or hypercoagulable state; History of intracranial hemorrhage; Known allergy or hypersensitivity to apixaban; Current therapeutic anticoagulation (any indication); Inability to comply with study protocol or follow-up.