Dialysis Access Consortium GRAFT

The Dialysis Access Consortium (DAC) was developed to investigate interventions to improve hemodialysis vascular access outcomes in patients with end-stage renal disease (ESRD). The Aggrenox Prevention of Access Stenosis Study (GRAFT) was one of two major clinical trials conducted under the DAC. Surgically created arteriovenous (AV) grafts are the most common type of hemodialysis vascular access in the United States, but fail frequently due to the development of venous stenosis. The GRAFT study was a double-blind, placebo-controlled randomized clinical trial designed to test whether treatment with Aggrenox (dipyridamole and low-dose aspirin) prolonged the primary unassisted patency of newly placed grafts. Participants undergoing placement of a new AV graft for hemodialysis were randomly assigned to receive treatment with Aggrenox or placebo immediately following access surgery. The primary outcome measure was loss of primary unassisted patency, defined as the time from access placement until thrombosis or requirement for intervention to maintain or restore patency. Major secondary outcome measures included cumulative access failure and death. The GRAFT study found that treatment with Aggrenox had a significant but modest effect in reducing the risk of stenosis and improving the duration of primary unassisted patency of newly created grafts.