Abstract: Objective  To explore the effects of structured exercise on blood flow in arteriovenous fistula (AVF), internal diameter of AVF vein, forearm depth of AVF vein, ultrasonic maturity rate and clinical maturity rate in patients with chronic kidney disease.  Methods  Relevant literatures from CNKI, Wanfang Database, VIP database, Chinese Biomedical Literature database, Embase, Medline, Web of Science and Cochrane Library were systematically searched until August 2024. Two researchers conducted data extraction and meta-analysis of the included references.  Results  A total of 10,736 literatures were retrieved, and 11 literatures with a total of 941 subjects were extracted. The meta-combined results showed that in patients after AVF surgery treated with structured exercise compared those treated with routine nursing/exercise, the blood flow in AVF was greater (SMD=1.39, 95% CI: 0.74～2.03, P＜0.01), the internal diameter of AVF vein was larger (SMD=0.95, 95% CI: 0.35～1.51, P＜0.01), the forearm depth of AVF vein was smaller (SMD=-1.49, 95% CI: -2.57～0.40, P＜0.01), the ultrasonic maturity rate was 1.43 times higher (95% CI: 1.28~1.59, P＜0.01), and the clinical maturity rate was 1.58 times higher (95% CI: 1.23～2.43, P＜0.01). Subgroup analysis showed that in patients beginning structured exercise after surgery for one week compared those beginning structured exercise after surgery within a week, the changes of blood flow in AVF was greater (structured exercise after surgery for one week: SMD=2.44, 95% CI: 1.16～3.72, P＜0.01; structured exercise after surgery within a week: SMD=0.62, 95% CI: 0.30～0.95, P＜0.01); in patients with structured exercise after surgery for one week compared those with conventional nursing exercise after surgery for one week, the forearm depth of AVF vein was smaller (SMD=-2.38, 95% CI: -3.89～-0.86, P＜0.01).  Conclusion  Structured exercise after AVF surgery can promote AVF maturation, increase blood flow in AVF and AVF vein diameter, reduce forearm depth of AVF vein, and improve ultrasonic maturity rate and clinical maturity rate of AVF. We recommend that medical staff should develop individualized and structured exercise program for patients after AVF surgery.

Key words: Chronic kidney disease, Arteriovenous fistula, Structured exercise, Maturity