Electrophysiological abnormalities in upper extremities after brachiocephalic A-V fistulas construction in predialysis patients

Kamal Hassan, Saab Amir, Sulla Michael, Waleed Simri, Mahmoud Haj, Shaul M. Shasha, Batya Kristal

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Peripheral neuropathy is considered a common complication in patients suffering from advanced chronic kidney disease (CKD). Superimposed peripheral multiple neuropathies may complicate arteriovenous (A-V) fistulas construction. Aim: To evaluate, prospectively, the influence of brachiocephalic A-V fistulas construction on the peripheral nerves of the same extremity and to characterize the patients at risk for developing ischemic and neurological complications. Patients and Methods: Twenty patients suffering from advanced CKD were enrolled in the study: 10 diabetic and 10 non-diabetic patients. All patients underwent electrophysiological evaluation one week before, 3 weeks and 3 months after surgery. Median, ulnar and radial nerves were studied. Results: In non-diabetic patients MNCV was normal before and after surgery, but were significantly lower and reduced progressively and significantly after surgery in diabetic patients (p≤0.02). In both non-diabetic and diabetic patients SNCV was reduced, but were significantly lower in diabetic patients before and after surgery (p≤0.03). In diabetic patients it reduced progressively and significantly after surgery (p<0.01). Thirty percent of patients developed local edema and significant decrease of CMAP of median nerve three weeks after surgery (p=0.02) with complete resolution at three months. Conclusion: Diabetic uremic patients are at increased risk to develop disabling neurological complications after the construction of A-V fistulas. Diabetes was the only predictive risk factor for developing these complications. Prevention requires careful preoperative electrophysiological evaluation and postoperative follow-up.

Original languageEnglish
Pages (from-to)111-117
Number of pages7
JournalRenal Failure
Issue number2
StatePublished - 2004
Externally publishedYes


  • A-V fistula
  • Conduction velocity
  • Electrophysiological studies
  • Neuropathy
  • Predialysis


Dive into the research topics of 'Electrophysiological abnormalities in upper extremities after brachiocephalic A-V fistulas construction in predialysis patients'. Together they form a unique fingerprint.

Cite this