Abstract: Objective To evaluate the function of both upper limbs in right-handed maintenance hemodialysis (MHD) patients with arteriovenous fistula or graft for blood access, and to understand the influence of arteriovenous fistula or graft on upper limb function and the factors influencing the limb function at arteriovenous fistula or graft side.  Method  This was a cross-sectional study. Right-handed patients with arteriovenous fistula or graft from six hemodialysis centers in Beijing were enrolled. Demographic, biochemical data and upper limb function indexes including grip strength, range of joint motion, and Simple Test for Evaluating Hand Function (STEF) were collected. t test or non-parametric test was used to compare the upper limb function of arteriovenous fistula or graft side and non-fistula or graft side. Multivariate linear regression was used to analyze the influencing factors for grip strength at the arteriovenous fistula or graft limb side in MHD patients.  Results  A total of 90 MHD patients were enrolled, 51(56.7%) of the patients were males, the mean age was 59.63±10.60 years, and the median dialysis vintage was 62.50(24.00, 113.00) months. The grip strength of non-fistula or graft side was higher than that of fistula or graft side (23.03±10.77 vs. 20.66±10.52, t=-5.133, P＜0.001). Multivariate linear regression demonstrated that the grip strength at fistula or graft side was positively correlated to serum creatinine (β=0.353, P＜0.001) and cognitive function (β=0.223, P=0.006), and was negatively correlated to urea clearance index (Kt/V) (β=-0.235, P=0.007). The grip strength at fistula or graft side was higher in males than in females (β=-0.253, P=0.004). The motion range of carpal joint turned to ulnar side was greater in the non-fistula or graft limb than that in the fistula or graft limb (32.85±10.81 vs. 29.92±9.46, t=-2.814, P=0.006). In the STEF tests, the operation time for large ball (8.17±1.78 vs. 7.99±1.78，t=2.327，P=0.021), large disc (7.29±1.91 vs. 7.02±1.84，t=2.472，P=0.015) and cloth  (7.36±2.06 vs. 7.13±1.84，t=2.688，P=0.008) were longer in the fistula or graft side than those in the non-fistula or graft side, with the differences reached statistical significances (P＜0.05).  Conclusions  The grip strength, range of joint motion and flexibility were decreased in the fistula or graft side. The factors affecting the grip strength in fistula or graft side included gender, serum creatinine, Kt/V and cognitive function.

Key words: Maintenance hemodialysis, Upper limb function, Arteriovenous fistula or graft