Effect of Pre-operative Forearm Exercises on Arterial Venous Fistula Maturation and Blood Flow

The incident and prevalent population on renal replacement therapy for End Stage Renal Disease (ESRD) is steadily increasing in Singapore as well as other countries worldwide. Around 85 ‐ 90% of the prevalent dialysis population is on Hemodialysis and Arteriovenous Fistula (AVF). AVF is considered the Gold standard for safe and effective vascular access for hemodialysis treatment due to its low rates of complication. However, Primary Failure rate of AVFs remain high at around 20 ‐ 25% depending on the site of the surgery, contributed by several factors including the diameter of the artery and the vein used for AVF formation. If Pre‐operative exercise improves the hemodynamics of the AVF and aids the maturation rate in our study, it can be incorporated into clinical guidelines to reduce the primary failure rate of AVF. Even though, there is sufficient evidence to support the beneficial role of the forearm exercises on fistula blood flow and maturation, there are no studies looking at the effects of Pre‐Operative Exercise on AVF maturation. Our Study is aiming to fulfil this gap in knowledge.