Arteriovenous fistula as a nephroprotective intervention in advanced CKD: scientific discovery and explanation, and the evaluation of interventions

Nephrol Dial Transplant. 2015 Dec;30(12):1939-41. doi: 10.1093/ndt/gfv281. Epub 2015 Aug 1.


… limitations notwithstanding, the hypothesis that AV fistula may retard CKD progression has passed the first very large mesh filter of a low-power observational study. The next step is to test the same hypothesis in existing, very large clinical databases by adopting advanced statistical techniques and by performing all of the sensitivity analyses needed to ponder the credibility of the results of such analyses. Ultimately, we should never forget that there are no shortcuts in the assessment of the efficacy of interventions. A randomized clinical trial will eventually be needed to assess the causal nature of the link between arteriovenous fistula and the rate of GFR loss in CKD.…

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