Same-day multiple-cannulation: A promising alternative method for establishing buttonhole tracks in hemodialysis patients—A multicenter randomized controlled trial

AIM: This study evaluated a novel same-day cannulation method for creating buttonhole tracks in arteriovenous fistulas of chronic hemodialysis patients. METHOD: Patients were randomized: the control (C) group had one sharp needle cannulation per dialysis, while the intervention (I) group had 4-6 cannulations during the first session to establish the BH track. The primary outcome was 1-year BH survival. Secondary outcomes included pain scores (numeric rating scale); sessions needed to create a BH track, and 1-year AV fistula failure and BH infection rates. RESULTS: BH survival and infection rates did not significantly differ between groups. The I-group had lower pain scores and required fewer sessions for track formation compared to the C-group. CONCLUSION: While the same-day cannulation method did not impact BH survival or infection rates, it improved patient comfort and reduced track formation time, potentially simplifying care for chronic hemodialysis patients. TRIAL REGISTRATION: Clinical Trials.gov ID: NCT03989141.