Abstract:
We have measured the blood flow to skin and muscle in normal
subjects, asymptomatic dialysis patients, and dialysis patients, and dialysis
patients who complained of cold hands (symptomatic patients) in whom a
radiocephalic fistula had been constructed. Mean skinblood flow in asymptomatic
dialysis patients was identical to that in normal subjects. Skinblood flow in the
fistula hand of symptomatic dialysis patients was greatly reduced but it was
normal in the contralateral hand. Muscle blood flow at rest was lower in dialysis
patients than in normal subjects, but was reduced still further in the fistula hand of
symptomatic patients. Muscle hyperaemia in response to exercise was greatly
impaired in the fistula hands of all patients, irrespective of symptoms. The
haemodynamic consequences of arteriovenous fistulae may be a cause of pain,
paraesthesiae, muscle wasting or claudication in dialysis patients.
