Scholarlink

Background and aims <p>Arteriovenous fistula (AVF) creation is a surgical procedure that involves connecting an artery and a vein, typically in the forearm or upper arm. This alteration in blood flow dynamics can indeed lead to nerve-related complications [<CitationRef CitationID="CR1">1</CitationRef>]. The aim of this work was to evaluate the electrophysiologic changes of peripheral nerves of the upper extremity after creation of AV access in end stage renal disease (ESRD) patients.</p> Methodology <p>This prospective study included 50 ESRD patients requiring upper limb AVF for hemodialysis. Electrophysiological evaluation was performed preoperatively and postoperatively to assess median, ulnar, and radial nerves for sensory and motor function, with parameters such as amplitude of compound muscle action potential, latency, and nerve conduction velocity being measured. Data were analyzed using IBM SPSS software package version 20.0, with statistical significance judged at the 5% level using Paired t-test for normally distributed quantitative variables and Wilcoxon signed ranks test for abnormally distributed quantitative variables.</p> Results <p>This prospective study included 50 ESRD patients requiring upper limb AVF for hemodialysis. Electrophysiological evaluation was performed preoperatively and postoperatively to assess median, ulnar, and radial nerves for sensory and motor function, with parameters such as amplitude of compound muscle action potential, latency, and nerve conduction velocity being measured. There was no statistically significant difference in sensory ulnar and radial nerve parameters after creation of the AVF. On the other hand, when comparing the motor parameters between the pre- and post-cases, a statistically significant decrease was observed in ulnar motor nerve amplitude ((<i>P</i> = 0.025). Comparing sensory parameters in diabetic and non-diabetic patients with upper limb AVF, no statistically significant difference was found. However, there was a significant decrease in motor radial nerve amplitude observed within the diabetic group (<i>P</i> = 0.006). Regardless of the type of AVF created, there was no statistically significant difference observed in any of the sensory nerve parameters measured. Conversely, the analysis reveals a statistically significant difference in motor ulnar nerve conduction velocity (CV) among the three shunt types (<i>p</i> = 0.036).</p> Conclusions <p>Significant changes of motor ulnar nerve conduction parameters were observed indicating potential neurological impact of AVF. Diabetes mellitus (DM) had no significant effect on either sensory or motor conduction parameters except motor radial nerve amplitude. No significant difference of either sensory or motor conduction parameters in different types of AVF when compared to each other except a significant ulnar nerve motor change.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Electrophysiologic study of upper extremity peripheral nerves following arteriovenous access creation in end stage renal disease patients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月13日

查看全文
  • Naylan Fayez Wahba Khalil,
  • Ali Ahmed Al-Emam,
  • Naguib Abd El-Kereem El-Askary,
  • Ahmed Samy Mohammed El-Sayed,
  • Sameh Moustafa El-Sayed

摘要

Background and aims

Arteriovenous fistula (AVF) creation is a surgical procedure that involves connecting an artery and a vein, typically in the forearm or upper arm. This alteration in blood flow dynamics can indeed lead to nerve-related complications [1]. The aim of this work was to evaluate the electrophysiologic changes of peripheral nerves of the upper extremity after creation of AV access in end stage renal disease (ESRD) patients.

Methodology

This prospective study included 50 ESRD patients requiring upper limb AVF for hemodialysis. Electrophysiological evaluation was performed preoperatively and postoperatively to assess median, ulnar, and radial nerves for sensory and motor function, with parameters such as amplitude of compound muscle action potential, latency, and nerve conduction velocity being measured. Data were analyzed using IBM SPSS software package version 20.0, with statistical significance judged at the 5% level using Paired t-test for normally distributed quantitative variables and Wilcoxon signed ranks test for abnormally distributed quantitative variables.

Results

This prospective study included 50 ESRD patients requiring upper limb AVF for hemodialysis. Electrophysiological evaluation was performed preoperatively and postoperatively to assess median, ulnar, and radial nerves for sensory and motor function, with parameters such as amplitude of compound muscle action potential, latency, and nerve conduction velocity being measured. There was no statistically significant difference in sensory ulnar and radial nerve parameters after creation of the AVF. On the other hand, when comparing the motor parameters between the pre- and post-cases, a statistically significant decrease was observed in ulnar motor nerve amplitude ((P = 0.025). Comparing sensory parameters in diabetic and non-diabetic patients with upper limb AVF, no statistically significant difference was found. However, there was a significant decrease in motor radial nerve amplitude observed within the diabetic group (P = 0.006). Regardless of the type of AVF created, there was no statistically significant difference observed in any of the sensory nerve parameters measured. Conversely, the analysis reveals a statistically significant difference in motor ulnar nerve conduction velocity (CV) among the three shunt types (p = 0.036).

Conclusions

Significant changes of motor ulnar nerve conduction parameters were observed indicating potential neurological impact of AVF. Diabetes mellitus (DM) had no significant effect on either sensory or motor conduction parameters except motor radial nerve amplitude. No significant difference of either sensory or motor conduction parameters in different types of AVF when compared to each other except a significant ulnar nerve motor change.