Assessment of hand dysfunction in patients receiving hemodialysis through arteriovenous fistula

Abstract

Objective: Patients receiving haemodialysis treatment generally tend to avoid using the upper extremity with arteriovenous (AV) fistulae and it results in impairment of hand functions. Limited data are available about impairment associated with hand complications in those patients The aim of this pilot study is to evaluate the handgrip and pinching strengths and functional level of both hands in patients receiving haemodialysis. Methods: Fifteen chronic renal failure patients receiving haemodialysis (30-83 years) and 11 age-matched healthy volunteers participated in the study. All the patients were undergoing treatment through arteriovenous fistulae in the upper extremity. Handgrip strength with a manual dynamometer and pinch strength with a pinchmeter were measured. Functional level of both hands was evaluated with Nine-Hole Peg Test. Results: Handgrip strengths of both hands were lower in patients receiving haemodialysis than healthy control group (p<0.01). Lateral, bipod and tripod pinching strengths were also lower in patients (p<0.05) with excepting right hand lateral pinching (p>0.05). 9-Hole Peg Test results in both placement and removal showed a great significant difference in both hands with a statistical significance of p<0.001. Conclusion: Our first results revealed that chronic renal failure patients receiving haemodialysis treatment through arteriovenous fistulae in the upper extremity have a significant impairment in strength and functional level of hand. The lack of differences between two hands may be concluded that the upper extremity impairment in patients results from the disease course or haemodialysis treatment, not from the vascular access. (English) [ABSTRACT FROM AUTHOR]