Effect of Post-Operative Exercise on Arteriovenous Fistula Maturation in Patients with Chronic Renal Failure: A randomized controlled trial.

Document Type : Original Article

Authors

1 Assistant Professor of Medical- Surgical Nursing, Faculty of Nursing, Matrouh University

2 Assistant Professor of Medical- Surgical Nursing, Faculty of Nursing, Damanhour University

3 Assistant Professor of Medical- Surgical Nursing, Faculty of Nursing, Alexandria University and Assistant professor, Nursing Department, Alriyada College for Health Sciences, Jeddah, Saudi Arabia

10.21608/ejhc.2025.424292

Abstract

Background: Nearly half a million people requiring hemodialysis, with approximately 100,000 new cases of end-stage renal disease (ESRD) on an annual basis. long-term survival of hemodialysis patients depends on the creation and maintenance of adequate vascular access. Accesses that were nonfunctional after six weeks of maturation are considered primary failures.  Aim of the Study: This study aimed to evaluate the effect of post-operative exercise on arteriovenous fistula (AVF) maturation in patients with chronic renal failure. Subjects and methods: Study design: A parallel-group, 2-arm randomized controlled trial of exercise programs for AVF maturation, with single-blind design. Setting: The study conducted at vascular outpatient's clinic, Alexandria Main University Hospital, Alexandria governorate, Egypt. Participants: A purposive sample patient who admitted to the above-mentioned setting who are candidates for AVF creation were recruited. The sample size was 64 participants. Tools: Two tools were developed: Tool I: " Bio-demographic and clinical data assessment sheet " Tool II: " AVF Clinical maturation assessment sheet" Tool III: " AVF Ultrasound maturation ".  Results: The results revealed that there is early maturation in the study group over control with statistical significance differences after 2 weeks and after 6 weeks (P=0.032 and 0.001) respectively. After 12 weeks’ assessment 100% of study group and 93.75% of control group represent full AVF clinical maturation. Ultrasound maturation was showed significance difference after 6 weeks’ assessment in the cephalic vein (P=0.012) and brachial artery (P=0.025). Conclusion: Significant clinical maturation assessment of AVF by inspection, palpation and auscultation is earlier and more visible in the study group patients, Furthermore, ultrasonic evaluations revealed accelerated maturation timelines in all study group participants relative to the majority of patients in the control group. Recommendation: It is recommended to include exercise program postoperatively for patients undergoing AVF procedures in treatment plan of these patients. Replicate this study on larger samples and on patients with other types of hemodialysis accesses.

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