Arteriovenous fistula maturation clinical assessment for hemodialysis: a scoping review

Objective: To map the available research evidence for arteriovenous fistula maturation clinical assessment. Methods: A scoping review, with a search conducted between October and November 2019 at JBI, Cochrane, Virtual Health Library, PubMed, and CINAHL. Studies with patients over 18 years old, with pre-dialysis chronic kidney disease or already under hemodialysis, who underwent arteriovenous fistula surgery were included; available text; and in English, Spanish, and Brazilian Portuguese. Studies related to the postoperative phase or related to care with prostheses/arteriovenous grafts were excluded. Results: One thousand nine hundred and fifty-four eligible studies were identified; 38 made up the final sample. The study comprised studies between 1998 and 2018, with an international scope of the theme (94.7%). The professional who performed the assessment was predominantly the nurse or nursing team (47.4%), and assessment started in the immediate post-surgical period, even months after surgery. Among the clinical assessment techniques, 23 studies (60.5%) recommended physical examination and 15 (39.5%) the combination of medical history and physical examination. Conclusion: This review presented the mapping of evidence, in which arteriovenous fistula clinical assessment must include medical history and physical examination. Several elements related to the permeability and vascular responses of the access were presented. There was a predominance of professional nurses as evaluators. There was need for training to carry out the assessment, in addition to a more comprehensive assessment, with the application of the Nursing Theory and Standardized Languages and Process, which may provide with a new field of research and development in the area.