OBJECTIVE: The aim of this study was to determine whether a postoperative ambulatory controlled exercise program can increase arteriovenous fistulas (AVF) maturation at 1 month. MATERIAL AND METHODS: In this randomized study we included a subgroup of pre- dialysis and hemodialysis patients. After surgery, all patients were randomized to an exercise group or a control group. At 1-month postoperatively, clinical maturation (hemodialysis nurse) and ultrasonographic maturation (nephrology) was assessed in all patients. Descriptive statistics, Chi test and Student T-test were use for statistically study. RESULTS: 69 patients (48 men), 66.8 (13.8) years old and 65.2% in pre-dialysis status. After randomization we study 38 patients in exercise and 31 in control group, respectively. At 1-month after surgery, clinical and ultrasonographic maturation was assessed in 88.4% and 78.3% of AVF (Kappa = 0.539). Only one AVF deemed mature by ultrasound examination was considered immature by clinical examination. AVF localization was detected as a confounding factor for both clinical and ultrasonographic maturation, leading to a significant greater effect of exercise in maturation of distal AVF for clinical criteria (94.7% versus 60.0%; p = 0.019). CONCLUSIONS: (1) A postoperative controlled exercise program after AVF creation seems to increase 1-month clinical AVF maturation, specially in distal access. (2) We only observed one AVF deemed mature by ultrasound examination was considered immature by clinical examination. (3) According to our results we can recommend physical exercise on the development of native arteriovenous fistula under control by hemodialysis nurse.

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