Mariana Murea
Wake Forest University, NC·Medicine & Clinical Research
People with end-stage kidney disease often depend on hemodialysis, a treatment that filters the blood through a machine. Nearly half of patients starting hemodialysis are 65 or older.
- Fields
Medicine & Clinical Research
Public Health & Epidemiology
- Topics
end-stage kidney disease
kidney failure
hemodialysis
- Grants
- 1 known grant, through Aug 2027
What they work on
- Compare catheter-free dialysis days, access-related infections and deaths after fistula versus graft placement in a randomized trial of 262 hemodialysis patients aged 65 and older at 6 sites.
- Compare the costs of vascular access care between older adults randomly assigned to arteriovenous fistula or graft surgery.
- Measure patient-reported satisfaction with access-related outcomes after fistula versus graft placement in older adults with kidney failure and heart disease, peripheral artery disease or diabetes.
- Test whether objective and self-reported physical function before surgery predicts failure of a fistula or graft to mature into a usable dialysis access.
More about the research
Many begin with a central venous catheter, a tube placed in a large vein, which carries risks of infection, blood vessel problems and death. To reduce these risks, surgeons create a permanent access point in the arm. This can be a fistula, which joins an artery directly to a vein, or a graft, which connects them with a synthetic tube. Fistulas have long been considered the best choice, but recent studies suggest grafts may serve older adults better. No well-powered randomized trial has settled the question.
Why it matters
More than 300,000 older Americans with end-stage kidney disease rely on long-term hemodialysis, and their vascular access is their lifeline. This trial could provide the first high-quality, age-specific evidence on whether a fistula or graft is better for older patients. That evidence could guide surgeons and nephrologists, reduce catheter-related infections and costs, and support access choices that reflect patients' goals and preferences.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
Vikram Fielding-Singh
Stanford University, CA·Medicine & Clinical Research·Early-career
Evaluate how modifiable preoperative hemodialysis parameters relate to postoperative complications such as myocardial infarction, stroke, heart failure, arrhythmia and infection, using linked Medicare claims and dialysis-provider electronic health records.
Kevin Erickson
Baylor College of Medicine, TX·Medicine & Clinical Research
Measure the uptake of telemedicine by nephrologists and advanced practice providers for in-center maintenance hemodialysis care after COVID-19 waivers, using large administrative dialysis databases.
Arthur Matas
University of Minnesota, MN·Medicine & Clinical Research
Compare the long-term risk of end-stage kidney disease (ESKD, kidney failure requiring dialysis or transplant) and death between living kidney donors and healthy matched controls from the Rochester Epidemiology Project, with over 40 years of follow-up.
The school
Wake Forest University: 27 labs on PI Pages, $345M a year on research, 54 research doctorates a year.
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