Handgrip Exercise for Arteriovenous Fistula Maturation

Not Applicable

Completed

Interventions: Other: Post operative progressive handgrip exercise
Other: Treatment as usual

Brief Summary: The purpose of this study is to investigate whether post operative progressive forearm exercise is effective in improving arteriovenous fistula maturation in chronic kidney disease patients.

Detailed Description: The arteriovenous fistula is considered to be the gold standard form of access for haemodialysis patients, however only 37% of haemodialysis patients have this form of access. A possible explanation for this could be the high fistula failure rate due to the lack of maturation. Therefore interventions aimed at enhancing fistula maturation are warranted. One such intervention could be forearm exercise, however this recommendation is not evidence based. Therefore, the purpose of this study is to investigate whether a program of post operative progressive hand grip exercise can improve fistula maturation.

Recruitment & Eligibility

Inclusion Criteria

Stage 4-5 chronic kidney disease, attending for arteriovenous fistula creation in forearm

Exclusion Criteria

Are under the age of 18years;
Not able to exercise forearm safely (as decided by the patients consultant)
Have any other uncontrolled medical condition
Unable to withstand transiently raised systolic blood pressure by 35 mmHg and diastolic by 25 mmHg
Or are unable to give consent

Arm && Interventions

Group	Intervention	Description
Handgrip exercise	Post operative progressive handgrip exercise	Handgrip exercise - patients allocated to this intervention will carry out an eight week post operative progressive handgrip exercise training program
Treatment as usual	Treatment as usual	-

Primary Outcome Measures

Name	Time	Method
Venous Diameter.	3 months	Measurements were made using duplex ultrasonagraphy. Measurements were made at predetermined distances 5 to 10 cm proximal to the anastomosis (dependent on wound dressings and turbulent flow around the anastomosis). The scanning position for each patient was traced using transparent sheets which allowed analogous measurement positions for all scans. Cross sectional vascular diameter measurements were made using conventional grey scale B Mode imaging. Diameters were measured from the inner edges of the vascular wall (Wiese \& Nonnast-Daniel, 2004).

Secondary Outcome Measures