Effects of different vascular pathways in uremia patients undergoing maintenance hemodialysis

Objective To explore the effects of different vascular pathways in uremia patients with maintenance hemodialysis(MHD). Methods The clinical data of 154 uremia patients who underwent MHD was retrospectively analyzed. According to different vascular pathway methods, the patients were divided into arteriovenous fistula(AVF)group(n=80)and central venous catheter(CVC)group(n=74). The dialysis adequacy conditions, related indicators of nutrition and anemia, blood purification indexes, inflammatory markers, incidence rate of complications and left ventricular function were compared between the two groups. Results After 6 months of dialysis, the levels of blood urea nitrogen(BUN), inflammatory indicators, cysteine(Hcy), parathyroid hormone(PTH), 2-microglobulin(2-MG)levels in the two groups were significantly lower than those before dialysis(P<0.05); the decreases of BUN and inflammatory markers in the AVF group were significantly greater than those in CVC group, the urea clearance index(Kt/V), incidence rates of vascular pathway embolism and infection in the AVF group were significantly higher than those in CVC group(P<0.05). The levels of plasma albumin(ALB)and hemoglobin(Hb)in the AVF group were higher than those before dialysis and the CVC group(P<0.05). The incidence rate of left ventricular systolic dysfunction in the AVF group was significantly higher than that in CVC group(P<0.05). Conclusion MHD through AVF can improve dialysis adequacy, anemia and microinflammation status in patients with uremia, but will increase the risk of left ventricular systolic dysfunction.