Influence of arteriovenous fistula on daily living behaviors involving the upper limbs in hemodialysis patients: a cross-sectional questionnaire study

Abstract

BackgroundArteriovenous fistulae can restrict daily living behaviors involving the upper limbs in hemodialysis patients, but no studies have investigated the detailed effects of an arteriovenous fistula on routine life activities. Accordingly, many medical caregivers are unable to explain the effects of an arteriovenous fistula on daily life, particularly during non-dialysis periods, because they cannot observe them directly.MethodsThirty outpatients undergoing hemodialysis at 2 facilities scored the difficulty due to an arteriovenous fistula in performing 48 living behaviors during non-dialysis and 10 behaviors during dialysis into 5 grades in a comprehensive questionnaire survey. These behaviors were selected based on an open-answer pre-questionnaire administered to the 30 patients beforehand. The scores were also compared between dominant arm and non-dominant arm arteriovenous fistula groups.ResultsDuring non-dialysis, the difficulty scores of behaviors restricted out of concern for arteriovenous fistula obstruction (wear a wristwatch, hang a bag on the arm, carry a baby or a dog in the arms, wear a short-sleeved shirt, etc.) increased. The difficulties of “wear a wristwatch” and “hang a bag on the arm” were significantly higher in the non-dominant arm arteriovenous fistula group (both P < 0.05). In contrast, scores related to motor function (write, eat or drink, scratch an itch, etc.) increased remarkably during dialysis because of connection of the arteriovenous fistula to the dialysis machine. The difficulties of “write” and “eat or drink” were significantly higher in the dominant arm arteriovenous fistula group (both P < 0.05).ConclusionsSeveral key daily living behaviors restricted by an arteriovenous fistula were identified in this questionnaire survey. These results will be useful for pre-operative explanation of arteriovenous fistula surgery and arm selection in end-stage renal disease patients.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-1097-9) contains supplementary material, which is available to authorized users.

A three years’ experience of Arteriovenous Fistula (AVF) cases in a tertiary care hospital of East Java, Indonesia: a descriptive observational study

“…Therefore, the non-dominant arm plays a supplementary role or helps the dominant arm do vital work. 11 Our study also showed the result is persistent with the previous statement, which AVF in the non-dominant arm is likely more found in this study than in the dominant arm. In this study, we found subjects dominantly came with hypertension as underlying disease findings.…”

Study of Arteriovenous Fistula Cases in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

“…This is because it is always preferable to create in the non-dominant side as this will have lesser impact on day to day activities compared to the fistula created in dominant side. 19 Arteriovenous fistulas aren't the first method followed for vascular access for hemodialysis in Nepal. Among 82 patients requiring vascular access arteriovenous fistula creation was done in six patients with the majority of the patient having temporary venous access through the femoral vein.…”

Can the fistula arm be used to lift heavy items? Six-pound dumbbells versus handgrip exercise in a 6-month follow-up secondary analysis of a randomized controlled trial

“…19 After the AVF is established, not carrying heavy objects may affect the quality of life of the patient during nondialysis phases (quality of life was not quantified in the present study); the consequences of not carrying heavy objects can manifest as defects in motor function and concerns about AVF obstruction. 9 To prevent the deterioration of hand function and to maintain fistula function, hand rehabilitation programs are recommended for patients on longterm hemodialysis. As suggested in a previous study, daily exercise of the fistula arm had clinical benefits.…”

“…However, restrictions on activities of daily living can affect the quality of life of the patient during nondialysis phases. 9 Moreover, maintenance hemodialysis patients have severe functionally significant skeletal muscle wasting and excessive muscle fatigue. 10,11 Specifically, patients' muscle strength and exercise endurance are diminished.…”