Doesn't sound plausible. We'll ask.
Member
Lifting and Hemodialysis
In studying for my internal medicine board recertification, I came across a recommendation that anyone with an AV graft or fistula (used for access for hemodialysis) shouldn't lift anything greater than 5 lbs on the arm in which it was placed. I found little if any support in the literature for this recommendation.
I'm assuming that someone out there is training dialysis patients. Has anyone encountered this limitation? Is it an issue in the real world or is it excessive caution? Would this really clot off such access?
TMPHBITEU
Doesn't sound plausible. We'll ask.
Starting Strength Coach
Dialysis-dependent renal failure patients demonstrate gainz in strength and function with training...subject of a Cochrane meta-analysis a few years back, if memory serves.Originally Posted by Mark Rippetoe
AV fistulas are temperamental bastards, and I fucking hate them. First of all, they're kind of disgusting....but then so is dialysis. Second, when they bleed...it can be a real mess. Third, they do in fact clot off, quite often for no good reason, all the time. If the patient is training, the nephrologist will blame it on the barbell. No doubt about it. But how often will it happen? I have no way of knowing, and neither does anybody else. I have not encountered this particular clinical scenario, so I have neither canonical data nor field experience.
You pays your money and you takes your chances.
Member
Never thought about it before but sad to say, they ARE kind of disgusting!
Yeah, my guess too. I just couldn't find a basis for this rec in a quick medline search though and I'd never heard it before.
✓ Member
Andy Bolton has apparently been on dialysis for some time (check his Instagram and the Google). I'm not sure if he has either of these two types of fixtures, but I've seen videos of him training regularly with some sort of semi-permanent looking tubing in his arm. While he's not deadlifting a grand, he's certainly pulling and pressing way more than 5 lbs.
Member
I have no doubt they would blame the training, but it doesn't make any logical sense to me. I don't have any data, either, but just thinking about it, lifting is probably one of the best thinks you could do for cardiovascular health, so why would it predispose to AV fistula clotting?
TMPHBITEU
That's never been a problem for them.
Member
It's a VERY inspiring story but having read it online, it sounds like he had a central line, not a fistula or graft. That's a very different, more temporary form of access. But good on him for powering through this.
It looks like he's on the path to transplant. When he gets that, there'll be NO obstacle to heavy lifting!
Starting Strength Coach
Roll of Shame would not be a good idea, but other than that, yeah. I have a client in Europe s/p renal graft (transplant), doing well under the bar.
Sounds like Andy probably has a dialysis catheter, SVC or subclavian. Once it's in good position and scarred down, it should be fine. Bench presses might make me nervous, but that's prolly just the paranoid ER doc in me. I've never trained anybody with a dialysis catheter or a Quinton. I recently had a client on home IV Abx therapy with a PICC line for a few weeks. I was afraid his doc would shut him down for training, but he actually said to go for it. You just never know with those doctors.
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