Abstract: 【Abstract】Objective The aim of this cross-sectional study was to investigate clinical factors associated with access blood flow in maintenance hemodialysis (MHD) patients. Methods Ultrasound dilution (UD) was used to measure access flow (Qa), recirculation rate and cardiac output (CO). Multivariate logistic regression was performed to evaluate the contribution of the variables on access flow. Results A total of 117 MHD patients were included in this study. Their mean Qa was 896±454 ml/min. UD measurements classified 21 cases (17.9%) having Qa ＜500 ml/min, 85 cases (72.6%) having Qa 500~1,500 ml/min, and 11 cases (9.4%) having Qa ≥1,500 ml/min. Patients with diabetes had significantly lower Qa (t=4.615, P＜0.001) and higher prevalence of stenosis (t=5.356, P=0.029). Logistic regression analyses showed that diabetes history (OR 8.782, 95% CI: 1.862～41.412, P=0.006) and previous access surgery (OR 4.087, 95% CI: 1.082～15.437, P=0.04) were independently associated with lower access flow (Qa＜500 ml/min). Conclusions History of diabetes is the most important independent risk factor for lower access flow in MHD patients and may indicate long-term poor access patency. Access flow surveillance may be helpful in these patients. A prospective cohort study is on our schedule to further validate the findings from this study.

Key words: Hemodialysis, Ultrasound dilution, Vascular access, Access flow, Diabetes