Evidence Behind the Workshop
Research & Publications
The AVF Care Workshop is built on what we measure. Here we share the peer-reviewed research and conference work that comes out of training dialysis patients, caregivers and technicians to look after their fistulas.
Outcome of a Structured Education Model to Promote Self-Examination and Early Detection of Fistula Dysfunction
Selected for presentation at the 27th Congress of the Asian Society for Vascular Surgery and 33rd Annual Conference of the Vascular Society of India
The same patient-education initiative has also been accepted for presentation at the ASVS Scientific E-Poster Showcase during the 27th Congress of the Asian Society for Vascular Surgery and 33rd Annual Conference of the Vascular Society of India, being held from 8–10 October 2026 in New Delhi.
Presentation of this work on both a reputed peer-reviewed journal platform and an international vascular-surgery conference platform highlights the clinical relevance of structured AVF education and its potential to benefit dialysis patients through earlier recognition of fistula problems and timely specialist evaluation.
Impact of a Structured Education Model to Promote Self-Surveillance and Early Detection of Fistula Dysfunction
Journal of Vascular Surgery, Volume 84, Issue 1, e62 · July 2026
Patients, caregivers and home dialysis technicians were trained to detect critical AVF stenosis with a stethoscope. Patients who spotted a change in their fistula's sound were referred early, and 30 of 32 confirmed cases were successfully salvaged.
Read the abstract
Objectives
Often, advancing arteriovenous fistula (AVF) stenosis goes undetected until thrombosis or access loss occurs, particularly when repeated difficult cannulations are misinterpreted as a technical error rather than underlying vascular compromise. To address this diagnostic gap, we initiated the AVF Care Workshop, an educational model that trains dialysis patients, caregivers, and home dialysis technicians to detect critical AVF stenosis using stethoscope-based auscultation. This model is not intended as a diagnostic replacement but serves as a technical adjunct to support timely referral to vascular access teams.
Methods
Since November 2023, structured workshops have been conducted across multiple centers. Each session enrolled dialysis patients, encouraged to attend with a caregiver and their home technician to form a triad for reinforced learning. Training included basic use and placement of the stethoscope at the first puncture point to detect a normal continuous bruit (explained to patients as the continuous sound), use of proximal and distal compression to mimic AVF stenosis and produce a systolic-only bruit (interrupted sound), and recognition of the absence of bruit strongly suggests AVF or graft thrombosis, warranting urgent clinical escalation. Each participant received a Kidney Warrior Toolkit containing a stethoscope, compression cap, QR-coded educational videos, renal diet guides, wristband, and a self-check visual magnet. Twice-a-month telephonic follow-up assessed compliance and outcomes.
Results
Among 251 trained patients, 186 (74%) regularly performed auscultation. Thirty-seven identified altered bruit patterns; 29 had confirmed AVF stenosis, and 3 had graft thrombosis. All findings were validated via Doppler and/or angiography. Thirty of 32 underwent successful salvage (93.7% salvage rate). Prior AVF intervention correlated with higher compliance and detection accuracy.
Conclusions
The AVF Care Workshop is a reproducible, scalable, and low-resource model that enables timely recognition of critical AVF stenosis. It complements formal surveillance and enhances timely salvage, improving long-term access outcomes.
