<i>In silico</i> study on effects of temperature change on hemodynamics of arteriovenous fistula and risk of postoperative complication

Arteriovenous fistula (AVF) serves as a critical vascular access for hemodialysis patients, and its successful establishment is paramount for ensuring effective hemodialysis treatment. Temperature variations can significantly alter the physical properties of blood, potentially leading to unstable flow patterns within the AVF. Despite its clinical relevance, research on the effects of temperature-induced changes in blood rheological parameters on AVF internal flow dynamics remains limited. This study aims to explore the impact of temperature on AVF hemodynamics and its potential influence on postoperative complications. By incorporating a temperature-dependent non-Newtonian blood viscosity model and the Andrade viscosity model, fluid-structure interaction simulations were performed on an idealized AVF bifurcation under both cold (10 °C) and hot (30 °C) conditions. The results revealed distinct hemodynamic differences between these temperature extremes, which could exacerbate postoperative complications. Specifically, under hot conditions, the anastomosis site was more susceptible to adverse effects, with an increased risk of intimal hyperplasia and other complications in the surrounding vascular regions. These findings underscore the importance of considering environmental temperature in the clinical management of AVF for hemodialysis, offering valuable insights for physicians to optimize patient outcomes.