Arteriovenous Fistula
Conditions
Keywords
Arteriovenous Fistula Diameter, Handgrip, Program exercise, Maturation
Brief summary
Arteriovenous fistula (AVF) is the recommended vascular access for chronic hemodialysis, as it is associated with less mortality and better patency than arteriovenous graft (AVG) or central venous catheter (CVC). Unfortunately, AVF suffers from a high failure rate, due, in part, to poor venous diameter. The aim of this study is to investigate whether a perioperative handgrip training can improve the diameter of AVF in patients with chronic kidney disease (CKD) (stage IV-V).
Interventions
PROCEDUREHandgrip exercise program
Handgrip exercise with a rubber ball 4 weeks before the surgery until 4 weeks after the surgery 20 contractions per minute for a total of 20 minutes each day.
Sponsors
Hospices Civils de Lyon
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients older than 18 years * with chronic kidney disease (Estimated Glomerular Filtration Rate (eGFR) \<30 milliLiter/minute (mL/min)) * with follow-up at the University Hospital of Lyon Sud * who choose hemodialysis as renal replacement therapy
Exclusion criteria
* contraindication for arteriovenous fistula (AVF) surgery * refusing AVF creation * prior vascular access * antecedent of IV substance abuse * active cancer * inability to perform handgrip exercise * physical or mental disability limiting follow-up possibility * inclusion in an other interventional study * no social welfare
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Arteriovenous Fistula (AVF diameter) | at 6 weeks (after surgery) | Arteriovenous Fistula diameter will be measured by Doppler ultrasound |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Echographic maturation rate | at 6 weeks (after surgery) | Maturation rate of Arteriovenous Fistula (AVF) by echography defined as blood flow\>600milliLiters/minute (mL/min), diameter\>6millimeters (mm) and depth \<6mm |
| Clinical maturation rate | at 6 weeks (after surgery) | Arteriovenous Fistula (AVF) measured by a vein easily palpable, relatively straight, with a uniform sensation of quivering and more than 10centimeters (cm) long. |
| Arteriovenous Fistula (AVF) localization (arm or forearm) | at 6 weeks (after surgery) | After the patient's examination, the vascular surgeon will choose the future AVF localization |
| Arteriovenous Fistula (AVF) interventions | up to 6 weeks | Necessity of performing an intervention (such as angioplasty or thrombolysis or thrombectomy or superficialization) on the Arteriovenous Fistula (AVF) |
| Emergency hemodialysis on Central Venous Catheter (CVC) | up to 6 weeks | Necessity of patients on CVC to undergo emergency hemodialysis |
| Emergency hemodialysis on Arteriovenous Graft (AVG) | up to 6 weeks | Necessity of patients on AVG to undergo emergency hemodialysis |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORAbbas DEEB, PhD
Hospices Civils de Lyon
Outcome results
None listed