#3099 Infrared thermography: a novel method to assess hand temperature and its association with ischemic signs and symptoms in dialysis patients

Abstract Background and Aims Arteriovenous (AV) fistula for hemodialysis can lead to significant alterations in circulation, sometimes causing hand ischemia. The diagnosis of ischemia is primarily clinical. This study aimed to evaluate the utility of infrared thermography in assessing vascular access-induced hand ischemia. Method Thirty-two dialysis patients underwent hand inspection, symptom evaluation suggestive of hand ischemia, and infrared thermal imaging (Fig. 1). Finger blood pressures were measured in both the AV fistula and non-fistula hands, along with the brachial artery pressure of the non-fistula side to calculate the digit-brachial index (DBI). Results Twenty-five patients had a native upper extremity AV fistula. Twelve (48%) of these patients had fistula hand temperature ≥1.0°C colder, while four (16%) had a warmer fistula hand compared to the non-fistula hand. However, finger pressures or DBIs did not differ between hands. None of the seven patients without fistula had a temperature difference ≥1.0°C between hands. Patients with either peripheral or coronary artery disease (n = 8) exhibited a greater temperature difference between the non-fistula and fistula hands compared to patients without cardiovascular disease (−1.64°C vs. −0.18°C, respectively, P = 0.040). Among all participants, 17 (53%) reported ischemic hand symptoms, though only five patients had clinical findings suggestive of ischemia. Symptoms did not correlate with temperature or finger pressure measurements. Conclusion Infrared thermography identified significant temperature differences between the AV fistula and non-fistula hands in hemodialysis patients. Ischemic symptoms were common but did not correlate with temperature differences or clinical findings. Patients with either peripheral or coronary artery disease showed statistically significant differences between fistula and non-fistula hand temperatures compared to patients without cardiovascular disease.