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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Vascular access dysfunction is a major cause of morbidity in end-stage kidney disease (ESKD) patients on maintenance hemodialysis. Arteriovenous fistulas (AVF) and grafts (AVG), although preferred access types, are frequently compromised by recurrent thrombosis, leading to access failure and increased healthcare utilization and costs. Apixaban, a direct oral anticoagulant (DOAC), widely prescribed for atrial fibrillation and venous thromboembolism, has emerging off-label use in dialysis patients. However, its impact on vascular access outcomes remains unclear. We evaluated the effect of apixaban on access thrombosis and bleeding complications in a large, multicenter dialysis network in Saudi Arabia.
We performed a quasi-experimental study using routinely collected data from 23 dialysis centers. For each patient, the frequency of AVF/AVG thromboses was compared during the 12 months preceding and following initiation of apixaban. Recurrent thrombosis was defined as two or more AVF/G thrombotic events within one year. Negative binomial regression was employed to model thrombosis incidence, accounting for overdispersion, with adjustment for age, sex, antiplatelet use, dialysis vintage, access anatomy, mean session duration, venous segment length, and access depth and diameter.
A total of 244 patients (137 women, 56.2%) with a mean age of 60.7 ± 13.8 years and a median dialysis vintage of 5 years (IQR 3–8) were included. Indications for apixaban were atrial fibrillation (42.2%), prosthetic cardiac valves (0.8%), and recurrent access thrombosis (57.0%). AVFs comprised 82.4% of accesses, with AVGs accounting for 17.6%. Nearly all patients (94.3%) received apixaban 2.5 mg twice daily.
In the multivariable model, the post-apixaban period was associated with a 65% lower rate of access thrombosis (IRR 0.35; 95% CI 0.24–0.53; p<0.001) after adjusting for potential confounders (Table 1). Bleeding occurred in 3.7% (95% CI 1.7–6.9%), none of whom required transfusion.
Apixaban therapy was associated with a significant reduction in recurrent AVF/G thrombosis and a low incidence of clinically significant bleeding, suggesting that apixaban may prolong access patency in patients on chronic hemodialysis. Rigorous randomized controlled trials may be required to confirm efficacy, define safety, and inform clinical practice guidelines for anticoagulation in this high-risk population.
