@article{77577a8ea6394ec9a5d2f65999e26947,
title = "A Randomized Trial of Postoperative Handgrip Exercises for Fistula Maturation in Patients With Newly Created Wrist Radiocephalic Arteriovenous Fistulas",
abstract = "Introduction: We aimed to substantiate the benefit of postoperative handgrip exercises (HGEs) in enhancing the maturation of an arteriovenous wrist fistula. Methods: We randomly assigned 119 patients aged 20 to 80 years who had wrist arteriovenous fistulas (AVFs) to undergo either a basic HGE program (group A), an advanced program (group B), or an advanced-plus upper arm banding program (group C). Outcomes were assessed by ultrasonographic evaluation of the diameter and flow at each follow-up. The attending nephrologist decided the clinical use of the fistula. Results: We identified no significant differences among the HGE groups in the mean diameter and blood flow 14, 30, 60, and 90 days after the creation of the wrist AVF (P = 0.55, 0.88, 0.21, and 0.19 for the diameter; 0.94, 0.81, 0.49, and 0.56 for the flow, respectively). The intent-to-treat analysis also found no difference in the clinical use of fistulas for hemodialysis (HD) (P = 0.997). Conclusion: In patients with a newly created wrist AVF, advancing frequency, with or without adding intensity using an upper arm tourniquet, of postoperative HGEs did not enhance the growth of the fistula or increase the rate of clinical use over 3 months. (ClinicalTrials.gov ID: NCT03077815).",
keywords = "exercise, hemodialysis, surgical arteriovenous shunt",
author = "Chen, {Jeng Wei} and Fu, {Hsun Yi} and Hii, {Ing Heng} and Tseng, {Hsien Wei} and Chang, {Po Ya} and Chang, {Chin Hao} and Chen, {Yih Sharng} and Hsu, {Ron Bin} and Wu, {I. Hui} and Chen, {Yung Ming} and Chu, {Tzong Shinn} and Hung, {Kuan Yu} and Lin, {Shuei Liong} and Wu, {Kwan Dun} and Chan, {Chih Yang}",
note = "Funding Information: This work was supported by the National Taiwan University Hospital [NTUH– 107–S3886 ] to conduct the research and prepare the article. Funding Information: We thank the staff of the National Taiwan University Hospital Statistical Consulting Unit for statistical consultation and analysis. We are also grateful to the renal team of the National Taiwan University Hospital for supporting our trial and for sharing their pearls of wisdom with us during this research. The renal division colleagues included Yung-Ming Chen, Tzong-Shinn Chu, Kuan-Yu Hung, Shuei-Liong Lin, Kwan-Dun Wu (the 5 authors listed), Fan-Chi Chang, Chih-Kang Chiang, Wen-Chih Chiang, Yu-Hsiang Chou, Down-Ming Huang, Jeng-Wen Huang, Chun-Fu Lai, Tai-Shuan Lai, Vin-Cent Wu, and Shao-Yu Yang. This work was supported by the National Taiwan University Hospital [NTUH–107–S3886] to conduct the research and prepare the article. The Institutional Review Board of the National Taiwan University Hospital approved the trial (201701043RINC). Written informed consent was obtained from all the patients. All procedures were performed in accordance with the ethical standards of the Declaration of Helsinki. The data supporting the findings of this study are openly available in a repository at URL: [https://aep.ntuh.gov.tw/public.php?service=files&t=Wq_7M4ULBuOLcgnY1uHYyy93MIPWfscMdtg2xye8AA_n7sOFil9eZGpagD9YKgI7]. J-WC contributed to conceptualization, methodology, investigation, writing of original draft, and visualization. H-YF contributed to methodology, investigation, and writing of original draft. I-HH contributed to methodology and investigation. H-WT contributed to methodology and investigation. P-YC contributed to validation, visualization, and funding acquisition. C-HC contributed to formal analysis. Y-SC contributed to resources and supervision. R-BH contributed to resources and supervision. I-HW contributed to supervision. Y-MC contributed to resources and supervision. T-SC contributed to resources and supervision. K-YH contributed to resources and supervision. S-LL contributed to resources and supervision. K-DW: contributed to resources and supervision. C-YC contributed to conceptualization, methodology, writing (review and editing), visualization, project administration, and funding acquisition. Publisher Copyright: {\textcopyright} 2022 International Society of Nephrology",
year = "2023",
month = mar,
doi = "10.1016/j.ekir.2022.12.019",
language = "English",
volume = "8",
pages = "566--574",
journal = "Kidney International Reports",
issn = "2468-0249",
publisher = "Elsevier Inc.",
number = "3",
}