Elderly patients, isometric exercise, and native vascular access maturation: An unsolved question?

Area of Science:

• Nephrology
• Vascular Surgery
• Geriatrics

Background:

• Increasing number of elderly patients require hemodialysis.
• Vascular access (VA) selection and management in this population present unique challenges.
• The impact of postoperative isometric exercises on native VA maturation in the elderly is not well-established.

Purpose of the Study:

• To evaluate the effect of postoperative isometric exercises on native VA maturation in patients over 75 years old with advanced chronic kidney disease.

Main Methods:

• A 24-month, single-center randomized study.
• Exercise group (EG) performed isometric exercises; control group (CG) received usual care.
• Assessed handgrip strength, Doppler ultrasound (DUS), VA complications, and maturation at 4 and 8 weeks.

Main Results:

• 27 elderly patients (mean age 79.9 years) were included.
• The EG showed significant increases in handgrip strength and higher rates of clinical (78.6% vs. 46.2%) and DUS maturation (71.4% vs. 30.8%) at 8 weeks.
• Lower incidence of VA stenosis was observed in the EG (7.1% vs. 23.1%).

Conclusions:

• Postoperative isometric exercises should be considered for elderly patients undergoing native VA creation.
• This intervention may improve the likelihood of achieving a mature, functional arteriovenous fistula.
• Further research is needed to validate these findings in the elderly population.