title: Effect of arteriovenous fistula and usage of arm with fistula on bone mineral density in hemodialysis patients.
abstract: We aimed to determine the incidence of osteoporosis in hemodialysis patients, to evaluate the differences due to arteriovenous fistula on bone mineral density (BMD) and to investigate whether usage of arm with fistula has an effect on BMD. In this cross-sectional study, 96 patients with chronic renal disease undergone to dialysis were included. Place of fistula (radial and brachial) and dominant hand were recorded. All patients were asked to complete Likert's scale in order to determine the frequency of their usage of arm with fistula. Patients were assigned in two groups: age >51 and < 50 years. Age-matched control group included 60 subjects. BMD measurements were done on lumbar vertebra, femur and both forearms. BMD measurement of proximal femur and total radius were significantly lower in patients >50 years compared to healthy controls and bone density measurement of lumbar vertebra, proximal femur, 1/3 distal and total radius were significantly lower in patients < 50 years compared to healthy controls (p < 0.05). BMD measurement was significantly lower in arms with fistula, especially with radial fistula, compared to both arms without fistula and healthy controls (p < 0.05). When all patients were evaluated, BMD scores were lowering by increasing age, duration of dialysis and fistula and decreasing usage of arm with fistula. BMD in hemodialysis patients is lower than normal population. BMD of arm with fistula is lower than arm without fistula and healthy controls. Both radial and brachial fistula affect negatively ipsilateral BMD. Movement of arm with fistula has positive effects on BMD.
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Hitit University Training and Research Hospital , Corum , Turkey ;
authors.forename: Ayla Cagliyan
authors.initials: AC
authors.lastname: Turk
authors.affiliation: b Department of Physical Medicine and Rehabilitation, Faculty of Medicine , Pamukkale University , Denizli , Turkey ;
authors.forename: Fusun
authors.initials: F
authors.lastname: Sahin
authors.affiliation: c Department of Nephrology , Hitit University Training and Research Hospital , Corum , Turkey ;
authors.forename: Sultan
authors.initials: S
authors.lastname: Ozkurt
authors.affiliation: d Department of Biostatistics, Faculty of Medicine , Ondokuzmayıs University , Samsun , Turkey ;
authors.forename: Leman
authors.initials: L
authors.lastname: Tomak
authors.affiliation: e Department of Nuclear Medicine , Edirne Training and Research Hospital , Edirne , Turkey.
authors.forename: Gurkan
authors.initials: G
authors.lastname: Guray
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000209:etiology; D006435:Renal Dialysis
keywords: Arteriovenous fistula; exercise; hemodialysis; measurement of bone density; osteoporosis