Which outcome is expected from regular fistula vessel exercises?

• A. Decreased fistula flow
• B. Enlargement of the vein
• C. Increased infection risk
• D. No vascular change

Answer: (B)

Regular fistula vessel exercises encourage the vein to adapt by dilating as blood flow increases during the exercises. The repetitive squeezing and releasing boost venous return, creating shear stress on the vessel walls that signals remodeling. This leads to a larger lumen and a stronger, more transplantable access site over time, which is why enlargement of the vein is the expected outcome. The other options don’t reflect this vascular remodeling process: exercises aren’t meant to decrease flow or directly raise infection risk, and some change in the vessel is expected with maturation rather than no change.