Effects of arteriovenous fistula massage on shunt patency and stenosis in hemodialysis patients

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  • Yoshikawa Tomoe
    Dialysis Unit, Jichi Medical University Hospital
  • Masuda Takahiro
    Division of Nephrology, Department of Internal Medicine, Jichi Medical University
  • Sugase Taro
    Division of Nephrology, Department of Internal Medicine, Jichi Medical University
  • Kobayashi Reiko
    Dialysis Unit, Jichi Medical University Hospital
  • Matsuoka Ryo
    Department of Clinical Engineering, Jichi Medical University Hospital
  • Yamada Keiko
    Faculty of Nursing, Seitoku University
  • Kasano Kayoko
    Dialysis Unit, Jichi Medical University Hospital
  • Saito Osamu
    Division of Nephrology, Department of Internal Medicine, Jichi Medical University
  • Nagata Daisuke
    Division of Nephrology, Department of Internal Medicine, Jichi Medical University

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Other Title
  • 自己血管内シャントに対するシャント血管マッサージの有用性に関する検討
  • ジコ ケッカン ナイ シャント ニ タイスル シャント ケッカン マッサージ ノ ユウヨウセイ ニ カンスル ケントウ

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<p>In hemodialysis (HD) patients, arteriovenous fistulas (AVF) are sometimes massaged to maintain shunt patency, but few studies have examined the long-term effects of massaging AVF. Therefore, we massaged AVF for a maximum of ten months in nine HD patients and examined its effects on stenosis-related sounds and AVF function using a stethoscope and echo color Doppler ultrasound. Of the five patients in which AVF stenosis-related sounds were heard at the start of the study, the sounds disappeared within four to eight weeks. A comparison of the findings obtained before and after the AVF massage demonstrated that the mean flow volume (FV) increased from 782±27 to 800±29 mL/min, and the mean resistance index (RI) decreased from 0.520±0.007 to 0.512±0.008. Similar FV and RI values were recorded immediately after the AVF massage at zero and three months. In the three patients who had previously undergone percutaneous transluminal angioplasty of their shunts, the shunt patency period increased from 147±40 to 269±59 days. In conclusion, this study suggests that massaging AVF in HD patients can ameliorate stenosis and maintain shunt function and patency.</p>

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