Abstract: 【Abstract】Objective To evaluate the function of upper limbs with arteriovenous fistula (AVF) and its related factors in patients with maintenance hemodialysis (MHD). Methods A total of 67 MHD patients with regular hemodialysis for more than 3 months in Beijing Boai Hospital of China Rehabilitation Research Center were enrolled to evaluate the upper limb functions, including grip strength, pinch force, wrist motion and simple test for evaluating hand function (STEF). Results ①Grip strength: Grip strength of the upper limbs with AVF was lower than that of the upper limbs without AVF (24.22±12.54 vs. 26.05±11.01N, t=- 2.075,
P=0.042). Multivariate linear regression analysis showed that age, albumin and abnormal passive dorsal extension of the upper limbs with AVF were the independent risk factors for grip strength of the upper limbs with AVF (standardization coefficient β=-0.364, 0.408 and -0.231 respectively; P=0.002, 0.001 and 0.044 respectively). AVF was an independent risk factor for grip strength of dominant hand (standardization coefficient β=-0.345; P=0.006). ② Pinch force: Pinch force of the upper limbs withAVF had no significant difference with that of the upper limbs withoutAVF(thumb-forefinger: 6.24±3.78 vs. 6.19±2.13N, t=0.104, P=0.918; thumb-middle finger: 4.69 ± 1.70 vs. 4.83 ± 1.57N, t=- 0.820, P=0.417; thumb- ring finger: 2.97 ± 1.35 vs. 3.10 ± 0.99N, t=-0.808, P=0.423). ③Wrist motion: The proportion of abnormal passive palmar curvature on the AVF side was higher than that on the non-AVF side (38.6% vs. 19.3%, c2=5.160, P=0.023). ④STEF: There were no significant
differences in the proportion of abnormal scoring (6% vs. 9%, c2=0.437, P=0.509), gross motor score (49 vs. 47, Z=-1.371, P=0.170), fine motor score (49 vs. 48, Z=-1.126, P=0.260) and total score (96 vs. 96, Z=- 1.285, P=0.199) between the upper limbs with AVF and those without AVF. Conclusion Compared with non-AVF limbs, the upper limbs with AVF have lower grip strength and abnormal passive palmar curvature in MHD patients. These dysfunctions have to be concerned by clinicians. Early intervention for the dysfunctions of grasp movement, and palmar curvature, dorsal extension and rotation of wrist joint on the AVF side should be carried out in order to improve quality of life and movement ability of MHD patients.

Key words: Hemodialysis, Upper limb dysfunction, Arteriovenous fistula