Raw data for hand and arm dysfunction following hemodialysis access placement

BACKGROUND: Patients with chronic or end-stage kidney disease (CKD/ESKD) often experience hand and arm dysfunction (HAD) following hemodialysis access placement, adversely affecting clinical outcomes and quality of life. Despite its prevalence, the underlying mechanisms of hemodialysis access-associated HAD remain largely unexplored. METHODS: We conducted a longitudinal study involving 30 patients with CKD/ESKD. Functional assessments, including grip strength, hand pressure, dexterity, sensory tests, and patient-reported HAD scores, were performed preoperatively and six weeks postoperatively. Brachioradialis muscle biopsies were analyzed for morphology, mitochondrial function, and transcriptomic profiles. Routine follow-up assessments were performed to determine functional hemoaccess success. RESULTS: Six weeks post-surgery, patients exhibited significant functional decline in the access limb. Postoperative grip strength declined by approximately 15% (P=0.0015), finger pressure decreased by ~30 mmHg (P<0.0001), and the perceived HAD score increased significantly (P=0.0450) compared to the preoperative values. In contrast, dexterity and digital sensation remained unchanged postoperatively. Muscle morphology analysis revealed an ~12% reduction in mean myofiber cross-sectional area (P=0.0340) which was significantly correlated with grip strength (P=0.0425). Postoperative assessment uncovered an increase in mitochondrial respiration and content, which inversely correlated with finger pressure (P=0.0423). However, net oxidative phosphorylation and antioxidant capacity remained unchanged. RNA sequencing revealed the most significant postoperative alterations in genes related to myofiber development. Notably, patients with HAD exhibited a ~15% higher rate of unassisted dialysis access failure compared to those without HAD, suggesting a possible link between HAD and access failure. CONCLUSIONS: This study revealed that approximately 70% of patients undergoing hemodialysis access placement experience HAD, with significant functional impairments linked to altered myofiber morphology, mitochondrial content, and transcriptomic profiles in individuals with CKD/ESKD. Importantly, patients with HAD had a higher rate of access failure, highlighting the clinical importance of early recognition and intervention to address HAD in patients undergoing hemodialysis access surgery.