Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effect of Forearm Exercise on Flow Mediated Vasodilation Prior to Arteriovenous Fistula Placement for Hemodialysis
Brief Summary: The study hypothesis is that 6 weeks of repetitive handgrip exercise will improve endothelial function and venous compliance in pre-dialysis patients with an estimated glomerular filtration rate of less than or equal to 20 ml/min. If proven correct then arm exercise might be useful to improve the success rate for a surgically created arteriovenous fistula in the forearm to become usable as a vascular access for hemodialysis.


Options:
A: Inclusion Criteria:

1. Patients who have established arteriovenous fistula
2. Patients whose muscle strength of the fistula limb is graded 4-5, which can overcome the 6-pound gravity and external resistance to complete the range of joint activity
3. Patients who provided informed consent.

Exclusion Criteria:

1. Left ventricular cardiac ejection fraction \<30%;
2. Using a arteriovenous graft or a long-term catheter as a permanent access;
3. The diameter of the aneurysm is greater than 2 cm or the aneurysm has a risk of rupture;
4. Participation in other clinical trials at the same time;
5. Severe cardiovascular diseases and other organ complications,malignant tumors, mental illnesses, etc.
B: Inclusion Criteria:

* Age exceeding the age of majority (18 years of age).
* Chronic renal failure with a calculated GFR (MDRD equation) less than or equal to 20 ml/min
* Eligible for creation of an arteriovenous fistula for the purpose of hemodialysis.
* The subject is expected to stay within driving distance of study site for at least 4 months.
* The subject's physician(s) will allow the patient to participate.
* Ability to give informed consent.

Exclusion Criteria:

* Unstable angina.
* Uncontrolled hypertension (resting blood pressure \>170 systolic or \>100 diastolic).
* Musculoskeletal or neurologic problem that prevents arm exercise.
* Currently functioning arteriovenous access in the same arm as the planned new fistula.
* Subjects who are eligible to participate in the ongoing DAC fistula trial.
* Planned new access surgery in less than 6 weeks
* Anticipated non-compliance with medical care based on physician judgment.
* Patient refusal.
C: Inclusion Criteria:

* Patients with Chronic Kidney Disease (CKD) stage 4 or 5;
* In conservative or dialysis treatment;
* Medical indication of arteriovenous fistula as an achievement of HD.

Exclusion Criteria:

* Cognitive impairment or changes that hinder understanding, realization of activities and interpretation of the issues;
* a history of making FAV in both upper limbs or some other type of vascular surgery in upper limbs, with some type of vascular access in upper limbs or in nearby regions;
* to develop some kind of manual work with heavy loads;
* Trauma-orthopedic lesions in the cervical, shoulder, elbow, wrist and untreated (or) hand;
* Signs of thrombophlebitis and hypoplasia / agenesis of the upper limbs.
D: Inclusion Criteria:

* Informed consent signature.
* Age between 18 and 89 years.
* Patients with advanced chronic kidney disease, stages IV-V, in pre-dialysis or prevalent HD patients, requiring new AVF.

Exclusion Criteria:

* Absence of adequate arteries and veins to allow autologous AVF. (The minimum gauges that will be considered in order to perform an autologous AVF are: artery caliber equal or greater than 1.6 mm and vein caliber equal or greater than 1,8 mm with a compressor).
* Diagnosis of coagulopathy or hemoglobinopathy of any cause.
* Patients who urgently need an AVF without the possibility of being 8 weeks on the surgical waiting list.
* Impossibility to perform the physical exercise protocol due to physical or mental disabilities or lack of social support.

Answer: B