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A Murine Model of Hemodialysis Access-Related Hand Dysfunction

A Murine Model of Hemodialysis Access-Related Hand Dysfunction

Published on: May 31, 2022

Decrease of muscle strength in vascular access hand due to silent ischaemia.

Tereza Kmentova¹, Anna Valerianova¹, Lucie Kovarova¹

¹1 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.

The Journal of Vascular Access

|March 17, 2018

Summary

This summary is machine-generated.

Vascular access for dialysis reduces hand perfusion, finger pressure, and muscle strength, even without overt ischaemia. These factors are interconnected, highlighting the impact of reduced blood flow on muscle health in end-stage renal disease patients.

Keywords:

Haemodialysis hand ischaemia hand muscle hand tissue oxygenation muscle strength vascular access

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Area of Science:

Nephrology
Vascular Surgery
Physiology

Background:

Vascular access creation for hemodialysis causes significant hemodynamic changes, leading to reduced hand perfusion.
This creates a model of hand ischemia, impacting distal limb muscles.

Purpose of the Study:

To investigate the influence of vascular access on hand muscle strength in end-stage renal disease (ESRD) patients.
To assess the relationship between dialysis access, hand perfusion, and muscle function.

Main Methods:

52 chronically hemodialyzed ESRD patients with upper limb access were studied.
Muscle strength (dynamometry), finger pressure, and thenar tissue oxygenation (near-infrared spectroscopy) were measured.
Data were analyzed using t-tests and correlation analysis.

Main Results:

Hands with dialysis access showed significantly lower handgrip strength, finger pressure, and thenar oxygenation compared to the contralateral hand.
Muscle strength on the access side correlated directly with thenar oxygenation and finger systolic pressure.
On the non-access side, strength correlated inversely with age, dialysis vintage, and red cell distribution width.

Conclusions:

Dialysis access decreases finger pressure, oxygenation, and muscle strength, even without evident hand ischemia.
These physiological parameters are interrelated, underscoring the consequences of impaired muscle perfusion in ESRD patients.
The findings highlight the importance of monitoring these parameters to understand the impact of vascular access on limb function.