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Upper limb isometric exercise protocolled programme and arteriovenous fistula maturation process.
Irati Tapia González1,2,3, Vicent Esteve Simó1,2, Sara Ibañez Pallares1,4
1Funtional Unit Vascular Access, Nephrology Department, Consorci Sanitari Terrassa, Barcelona, Spain.
Clinical Kidney Journal
|February 24, 2021
Summary
Post-operative isometric exercises significantly improved arteriovenous fistula (AVF) maturation in chronic kidney disease (CKD) patients. This exercise program enhanced both clinical and Doppler ultrasound maturation outcomes.
Area of Science:
- Nephrology
- Vascular Surgery
- Radiology
Background:
- Arteriovenous fistula (AVF) is the preferred vascular access (VA) for end-stage chronic kidney disease (CKD) patients.
- Post-operative exercises may enhance AVF maturation, but evidence is limited.
- This study investigates the impact of a post-operative isometric exercise program on AVF maturation.
Purpose of the Study:
- To assess the effect of a post-operative isometric exercise program on native AVF maturation in patients with stage 5-5D CKD.
Main Methods:
- A 24-month prospective study involving randomization of patients into an isometric exercise group (EG) or a control group (CG).
- The EG followed a protocolled isometric exercise program, while the CG received usual care.
- Demographic data, hand-grip strength, Doppler ultrasound (DUS) measurements, and AVF maturation were assessed at 4 and 8 weeks post-operatively.
Main Results:
- The EG showed a significant increase in hand-grip strength (P=0.001).
- Clinical AVF maturation was significantly higher in the EG at 4 weeks (70% vs 33.3%, P=0.009) and 8 weeks (76.7% vs 33.3%, P=0.002).
- DUS maturation was also superior in the EG at 4 weeks (80% vs 40%, P=0.003) and 8 weeks (83.3% vs 43.3%, P=0.003) for both distal and proximal VA territories.
Conclusions:
- A protocolled upper limb isometric exercise program effectively improved both clinical and DUS maturation of AVF.
- These findings suggest a potential benefit of isometric exercises for AVF maturation in CKD patients.
- Further research is warranted to validate these results.
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