Impact of a Structured Arm Exercise Program on Arteriovenous Fistula Maturation for Hemodialysis in Adults with Chronic Kidney Disease

What this Trial Is About

This research aims to evaluate whether a structured physical exercise program focused on the arm with an arteriovenous fistula AVF can improve the maturation and function of the AVF in patients with stage 5 Chronic Kidney Disease preparing to start hemodialysis. The AVF is the preferred vascular access for hemodialysis, but its maturation fails in 28% to 53% of cases, which complicates effective dialysis. Exercise is known to promote vascular remodeling, yet there is no consensus on the best exercise type, frequency, or intensity for AVF maturation. Participants are randomly assigned to either an exercise group or a control group. The exercise group follows a structured program involving progressive exercises using weights and therapeutic balls on the AVF arm, guided by a rehabilitation nursing specialist. The control group receives usual care recommendations without the exercise program. The study lasts about eight weeks, with two in-person visits scheduled at specialized nursing clinics where informed consent is obtained, instructions given, and data collected. During the study, participants will complete questionnaires, grip strength tests, and arm circumference measurements. Ultrasound and clinical evaluations of the AVF will assess vein diameter, wall thickness, blood velocity, and blood flow in the humeral artery. The exercise group will track adherence and any sensations or difficulties in a follow-up booklet. The study aims to increase functional AVFs and reduce complications, with all procedures conducted ethically and without cost or harm to participants.

Effect of a Structured Physical Exercise Program on Arteriovenous Fistula Maturation for Hemodialysis in Chronic Kidney Disease Patients