Nerve conduction changes following arteriovenous fistula construction in hemodialysis patients

Abstract

Peripheral neuropathy is a common complication of chronic renal failure (CRF). Superimposed neuropathies may complicate arteriovenous fistulas (AVF) construction. The aim of this study was to evaluate the effect of AVF construction on nerve conduction. Twenty-six patients were included in this prospective case-control study. All patients underwent clinical and electrophysiologic evaluations 1 week before and 3 months after AVF placement. A side-to-side fistula was set up for all patients, and the radial, ulnar, and median nerves were studied. Patient's non-fistula hand served as a control. No significant changes were observed on neurological examination of the upper limbs following AVF construction. In the case of motor nerves, the AVF hand had decreased amplitude of distal and proximal segments of the radial nerve (P = 0.025 and P = 0.042), proximal segment of the median nerve (P = 0.025), and increased distal latency of the ulnar nerve (P = 0.027). No significant changes were observed for sensory parameters. This study showed that all three nerves of the upper extremity can be affected by hemodialysis vascular access construction in patients with CRF, and the motor radial nerve was the most affected nerve.