According to a new study an 8-week preoperative isometric exercise program significantly increased cephalic vein diameter and improved the rate of radiocephalic arteriovenous fistula (AVF) creation, helping preserve more proximal veins for future vascular access. This study hypothesizes that isometric exercise, when implemented preoperatively can enhance vascular caliber, thereby improving AVF creation and maturation. Participants were allocated 1:1 to an 8-week isometric exercise regimen (grip strengthener and pétanque ball; n = 27) or control (n = 27). An 8-week preoperative isometric exercise protocol significantly improved cephalic vein arm diameter and increased radiocephalic AVF creation rate, a clinically meaningful shift that preserves proximal venous capital for future vascular access procedures. Effect of preoperative isometric hand exercise on vascular caliber in patients with advanced chronic kidney disease - a randomised controlled trial.