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International Urology and Nephrology

, Volume 43, Issue 3, pp 849–853 | Cite as

Nerve conduction changes following arteriovenous fistula construction in hemodialysis patients

  • Mahnaz TalebiEmail author
  • Behzad Salari
  • Hossein Ghannadan
  • Farzad kakaei
  • Sima Abedi Azar
Nephrology – Original Paper

Abstract

Background

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.

Materials and methods

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.

Results

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.

Conclusions

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.

Keywords

Nerve conduction study Arteriovenous fistula Hemodialysis Chronic renal failure 

Notes

Acknowledgments

Disclosure

The authors have no financial interests to disclose in relation to the content of this article.

References

  1. 1.
    Brouns R, De Deyn PP (2004) Neurological complications in renal failure: a review. Clin Neurol Neurosurg 107(1):1–16PubMedCrossRefGoogle Scholar
  2. 2.
    Krishnan AV, Kiernan MC (2007) Uremic neuropathy: clinical features and new pathophysiological insights. Muscle Nerve 35(3):273–290PubMedCrossRefGoogle Scholar
  3. 3.
    Bosch EP, Smith BE (2004) Disorders of peripheral nerves. In: Bradley WG, Daroff RB, Fenichel G et al (eds) Neurology in clinical practice, 4th edn. Butterworth Heinemann, PhiladelphiaGoogle Scholar
  4. 4.
    Tilki HE, Akpolat T, Coskun M et al (2009) Clinical and electrophysiologic findings in dialysis patients. J Electromyogr Kinesiol 19(3):500–508PubMedCrossRefGoogle Scholar
  5. 5.
    Rogers NM, Lawton PD (2007) Ischaemic monomelic neuropathy in a non-diabetic patient following creation of an upper limb arteriovenous fistula. Nephrol Dial Transplant 22(3):933–935PubMedCrossRefGoogle Scholar
  6. 6.
    Ropper AH, Brown RH (2005) Adams and victor’s principles of neurology, 8th edn. McGraw-Hill, New YorkGoogle Scholar
  7. 7.
    Bickley LS, Szilagyi PG (eds) (2005) Bates’ guide to physical examination and history taking, 9th edn. Lippincott Williams and Wilkins, PhiladelphiaGoogle Scholar
  8. 8.
    Bessias N, Paraskevas KI, Tziviskou E et al (2008) Vascular access in elderly patients with end-stage renal disease. Int Urol Nephrol 40(4):1133–1142PubMedCrossRefGoogle Scholar
  9. 9.
    NFK-K/DOQI Clinical Practice Guidelines for Vascular Access: update 2000 (2001) Am J Kidney Dis 37:S137–S181CrossRefGoogle Scholar
  10. 10.
    Rayner HC, Pisoni RL, Gillespie BW et al (2003) Creation, cannulation and survival of arteriovenous fistulae: data from the dialysis outcomes and practice patterns study. Kidney Int 63(1):323–330PubMedCrossRefGoogle Scholar
  11. 11.
    Stolic RV, Trajkovic GZ, Peric VM et al (2008) The influence of atherosclerosis and plasma D-dimer concentration in patients with a functioning arteriovenous fistula for maintenance hemodialysis. Int Urol Nephrol 40(2):503–508PubMedCrossRefGoogle Scholar
  12. 12.
    Acarturk G, Albayrak R, Melek M et al (2008) The relationship between arteriovenous fistula blood flow rate and pulmonary artery pressure in hemodialysis patients. Int Urol Nephrol 40(2):509–513PubMedCrossRefGoogle Scholar
  13. 13.
    Lin G, Kais H, Halpern Z et al (1997) Pulse oxymetry evaluation of oxygen saturation in the upper extremity with an arteriovenous fistula before and during hemodialysis. Am J Kidney Dis 29(2):230–232PubMedCrossRefGoogle Scholar
  14. 14.
    Castaigne P, Cathala HP, Beaussart-Boulengé L et al (1972) Effect of ischaemia on peripheral nerve function in patients with chronic renal failure undergoing dialysis treatment. J Neurol Neurosurg Psychiatry 35(5):631–637PubMedCrossRefGoogle Scholar
  15. 15.
    Sladky JT, Tschoepe RL, Greenberg JH et al (1991) Peripheral neuropathy after chronic endoneurial ischemia. Ann Neurol 29(3):272–278PubMedCrossRefGoogle Scholar
  16. 16.
    Oh SJ (1993) Clinical electromyography: nerve conduction studies, 2nd edn. Lippincott Williams and Wilkins, BaltimoreGoogle Scholar
  17. 17.
    Holtmann B, Anderson CB (1977) Carpal tunnel syndrome following vascular shunts for hemodialysis. Arch Surg 112(1):65–66PubMedGoogle Scholar
  18. 18.
    Harding AE, Le Fanu J (1977) Carpal tunnel syndrome related to antebrachial Cimino-Brescia fistula. J Neurol Neurosurg Psychiatry 40(5):511–513PubMedCrossRefGoogle Scholar
  19. 19.
    Martinelli P, Baruzzi A, Montagna P et al (1981) Carpal tunnel syndrome in a patient with a Cimino-Brescia fistula. Eur Neurol 20(6):478–480PubMedCrossRefGoogle Scholar
  20. 20.
    Poulenas I, Spertini F, Wauters JP (1983) The carpal tunnel syndrome in chronic dialysis patients, it is a late complication of the arterio-venous fistula? Ann Chir Main 2(3):244–249PubMedCrossRefGoogle Scholar
  21. 21.
    Shin J, Nishioka M, Shinko S et al (2008) Carpal tunnel syndrome and plasma beta2-microglobulin concentration in hemodialysis patients. Ther Apher Dial 12(1):62–66PubMedCrossRefGoogle Scholar
  22. 22.
    Klein C, Halevy A, Gandelman-Marton R et al (1996) Nerve conduction abnormalities in the arms of patients with arteriovenous fistula. Ren Fail 18(1):85–89PubMedCrossRefGoogle Scholar
  23. 23.
    Knezevic W, Mastaglia FL (1984) Neuropathy associated with Brescia-Cimino arteriovenous fistulas. Arch Neurol 41(11):1184–1186PubMedGoogle Scholar
  24. 24.
    Spertini F, Wauters JP, Poulenas I (1984) Carpal tunnel syndrome: a frequent, invalidating, long-term complication of chronic hemodialysis. Clin Nephrol 21(2):98–101PubMedGoogle Scholar
  25. 25.
    Zampollo A, Costanzo R, Locatelli F (1985) Arteriovenous fistula and nerve conduction velocity in patients on hemodialysis: statistical and electrographic findings. Ital J Neurol Sci 6(3):323–327PubMedCrossRefGoogle Scholar
  26. 26.
    Bussell JA, Abbott JA, Lim RC (1971) A radial steal syndrome with arteriovenous fistula for hemodialysis. Studies in seven patients. Ann Intern Med 75(3):387–394PubMedGoogle Scholar
  27. 27.
    Tordoir JH, Dammers R, Van der Sande FM (2004) Upper extremity ischemia and hemodialysis vascular access. Eur J Vasc Endovasc Surg 27(1):1–5PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • Mahnaz Talebi
    • 1
    • 2
    Email author
  • Behzad Salari
    • 2
  • Hossein Ghannadan
    • 1
  • Farzad kakaei
    • 3
  • Sima Abedi Azar
    • 4
  1. 1.Department of Neurology, Imam Reza HospitalTabriz University (Medical Sciences)TabrizIran
  2. 2.Neurosciences Research CenterTabriz University (Medical Sciences)TabrizIran
  3. 3.Department of SurgeryTabriz University (Medical Sciences)TabrizIran
  4. 4.Department of NephrologyTabriz University (Medical Sciences)TabrizIran

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