Abstract: Objective To investigate the vascular access modalities at the initiation of hemodialysis in maintenance hemodialysis (MHD) patients, and to analyze the factors affecting the selection of vascular access modalities. Methods A total of 125 MHD patients were recruited from Shanghai Huashan Hospital during the period from Oct. 1, 2015 to Jan. 1, 2016. The vascular access modalities at the initiation of hemodialysis were described, and the factors relating to the selection of vascular access modalities were analyzed. Results Arteriovenous fistula was used at the initiation of hemodialysis in 53.6% MHD patients. There were significant differences in hypertension (24 vs. 43, χ2=6.042, P=0.014), time from diagnosis of renal disease to the initiation of hemodialysis [1.085(0.000～42.280) vs. 4.170 (0.170～40.112) years, Z=2.314, P=0.021], referral to nephrologists before the initiation of hemodialysis (23 vs. 53, χ2=19.496, P＜0.001), and period from suggestion of arteriovenous fistula operation by nephrologists to the initiation of hemodialysis [0.000 (- 36.505～13.201) vs. 4.100 (1.000～75.072) months, Z=7.748, P＜0.001] between the patients using central venous catheter and those using arteriovenous fistula. Conclusions The proportion of arteriovenous fistula for blood access at the initiation of hemodialysis was higher in this Blood Purification Center, but needs to be increased further. The selection of blood access modality at the initiation of hemodialysis was related to hypertension, time from diagnosis of renal disease to the initiation of hemodialysis, referral to nephrologists before the initiation of hemodialysis, and period from suggestion of arteriovenous fistula operation by nephrologists
to the initiation of hemodialysis.

Key words: hemodialysis, vascular access, arteriovenous fistula