Resumo

LOPEZ ALONSO, María Teresa; LOZANO MOLEDO, Valentín; YUGUERO ORTIZ, Anna  e  FONTSERE BALDELLOU, Néstor. Influence of physical exercise on the development of native arteriovenous fistulas. Enferm Nefrol [online]. 2015, vol.18, n.3, pp.168-173. ISSN 2255-3517.  https://dx.doi.org/10.4321/S2254-28842015000300004.

Objective: The aim of this study was to determine whether a postoperative ambulatory controlled exercise program can increase arteriovenous fistulas (AVF) maturation at 1 month. Material and Methods: In this randomized study we included a subgroup of pre- dialysis and hemodialysis patients. After surgery, all patients were randomized to an exercise group or a control group. At 1-month postoperatively, clinical maturation (hemodialysis nurse) and ultrasonographic maturation (nephrology) was assessed in all patients. Descriptive statistics, X² test and Student T-test were use for statistically study. Results: 69 patients (48 men), 66.8 (13.8) years old and 65.2% in pre-dialysis status. After randomization we study 38 patients in exercise and 31 in control group, respectively. At 1-month after surgery, clinical and ultrasonographic maturation was assessed in 88.4% and 78.3% of AVF (Kappa = 0.539). Only one AVF deemed mature by ultrasound examination was considered immature by clinical examination. AVF localization was detected as a confounding factor for both clinical and ultrasonographic maturation, leading to a significant greater effect of exercise in maturation of distal AVF for clinical criteria (94.7% vs 60.0%; P = 0.019). Conclusions: 1.- A postoperative controlled exercise program after AVF creation seems to increase 1-month clinical AVF maturation, specially in distal access. 2.- We only observed one AVF deemed mature by ultrasound examination was considered immature by clinical examination. 3.- According to our results we can recommend physical exercise on the development of native arteriovenous fistula under control by hemodialysis nurse.

Palavras-chave : chronic kidney disease stage 5 (pre-dialysis) and 5D (hemodialysis); vascular access; native arteriovenous fistula; physical exercise.

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