Maintenance of vascular access for hemodialysis is one of the major challenges in the care of the hemodialysis patient. Access-related problems are among the most frequent reasons for hospitalization in the end-stage renal disease population, and the cost of vascular access placement and repair in the United States exceeds $700 million per year. Our center participates in an NIDDK-funded consortium of investigators, consisting of seven clinical centers and a data-coordinating center to undertake interventional clinical trials to improve outcomes in patients with fistulas and grafts. Two randomized placebo controlled clinical trials have been designed and are planned to begin recruitment in late 2002. Two clinical trials are currently active. The first trial evaluates the effects of the anti-platelet agent, clopidogrel on prevention of early fistula failure. A second trial studies the effects of Aggregonox in the prevention of vascular graft stenosis and thrombosis in hemodialysis patients.
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