Influence of muscle training on resting blood flow and forearm vessel diameter in patients with chronic renal failure.

Abstract

Blood flow and vessel diameter are predictors of the success of vascular access procedures. This study investigated whether a simple exercise programme could influence these variables. Twenty-three patients with chronic kidney disease were prescribed a simple exercise programme for one arm only; the investigators were blinded to the patients' choice. All underwent arterial and venous duplex imaging, handgrip strength and blood pressure measurements before and 1 month after the exercise programme. Twelve patients exercised their dominant and 11 their non-dominant arm. In the trained arm, the exercise programme resulted in a significant increase in handgrip strength, by a median (interquartile range) of 4 (0-8) kg (P < 0.001), and in the diameter of the brachial artery (0.2 (0.1-0.3) mm; P < 0.001), radial artery (0.3 (0.2-0.4) mm; P < 0.001), and cephalic vein (0.6 (0.4-1.2) mm in the forearm and 1.1 (0.4-1.2) mm above the elbow; P < 0.001). There was an increase in brachial artery mean velocity (3 (1-7) cm/s; P = 0.009) and peak systolic velocity (8 (1-15) cm/s; P = 0.020), despite a marginally lower systolic blood pressure (-8 (-16 to 0) mmHg; P = 0.007). There was no change in any of these parameters in the non-exercised arm. In patients with chronic kidney disease, forearm exercise increased blood flow and vessel diameters. This may be beneficial before vascular access formation.