Impact of load and movement on arteriovenous fistula flow

Introduction: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. Whether acute arm movement impacts arteriovenous fistula (AVF) blood flow is unknown. Methods: In this cross-sectional analysis, we evaluated AVF blood flow using an ultrasound device at resting and after three muscle movements for proximal (elbow flexion, shoulder adduction and abduction) or distal AVF (fist extension and flexion, fingers squeeze), without and with a 2 kg load. Results: We included 23 patients (14 men), 53 ± 13 years, 26.1% with diabetes, on dialysis for a median time of 5.2 months. At rest, blood flow in proximal and distal AVF were 4355 (2470, 7233) mL/min and 2286 (2063, 2442) mL/min, respectively. There was no significant difference between blood flow at resting and any movement before and after load in either proximal or distal AVF ( p > 0.05 for all comparisons). Conclusion: Acute arm movement with or without load does not significantly alter the blood flow of mature AVF. These results demystify the general belief that patients should avoid AVF arm movement.