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

Condition(s) studied

Investigational drug(s) / intervention(s)

Physical exercise program: Evaluation of AVF maturation using clinical and ultrasound criteria, after applying a structured physical exercise program.

Study summary

For patients living with Chronic Kidney Disease who are preparing to start hemodialysis, having a well-functioning arteriovenous fistula (AVF) is essential. Although the AVF is considered the best type of vascular access, its maturation process does not always go as expected-studies show that in 28% to 53% of cases, the fistula does not mature properly, making effective dialysis more difficult. There is growing interest in using physical exercise as a way to support AVF maturation. International guidelines even recommend arm exercises for this purpose. However, there is still no clear agreement on what type of exercise, how often, or how intense it should be. This study aims to evaluate whether a structured exercise program focused on the AVF arm can help improve the fistula's development and overall function.

Eligibility

Primary outcome measure(s)

• Evaluation of AVF maturation using clinical and ultrasound criteria: Diameter of the drainage vein (mm) — 8 weeks
  -Diameter of the drainage vein (mm). Eight weeks after the application of a physical exercise program, patients in the intervention and control groups will be evaluated through a physical examination (presence of thrill and continuous murmur, increased venous diameter, absence of complications such as stenosis or thrombosis) and ultrasound examination.
• Evaluation of AVF maturation using clinical and ultrasound criteria: Venous wall thickness (mm) — 8 weeks
  \- Venous wall thickness (mm). Eight weeks after the application of a physical exercise program, patients in the intervention and control groups will be evaluated through a physical examination (presence of thrill and continuous murmur, increased venous diameter, absence of complications such as stenosis or thrombosis) and ultrasound examination.
• Evaluation of AVF maturation using clinical and ultrasound criteria: Blood velocity (cm/sec) — 8 weeks
  \- Blood Velocity (cm/sec). Eight weeks after the application of a physical exercise program, patients in the intervention and control groups will be evaluated through a physical examination (presence of thrill and continuous murmur, increased venous diameter, absence of complications such as stenosis or thrombosis) and ultrasound examination.
• Evaluation of AVF maturation using clinical and ultrasound criteria: Blood flow volume in the humeral artery (mL/min) — 8 weeks
  \- Blood flow volume in the humeral artery (mL/min). Eight weeks after the application of a physical exercise program, patients in the intervention and control groups will be evaluated through a physical examination (presence of thrill and continuous murmur, increased venous diameter, absence of complications such as stenosis or thrombosis) and ultrasound examination.

Trial sites (1)

More Unidade Local de Saúde de Coimbra, EPE trials in Portugal