Abstract: 【Abstract】Objective To study the first and the present type of vascular access and its influencing factors in maintenance hemodialysis (MHD) patients in Bengbu city. Methods A questionnaire survey was conducted among the patients treated with hemodialysis for more than 3 months in the First and Second Affiliated Hospitals of Bengbu Medical College. Clinical data, the type of vascular access, blood flow and complications were then recorded. The distribution of different vascular access types in MHD patients was analyzed. The general conditions were compared between patients using arteriovenous fistula (AVF) and those using central venous catheter (CVC) at the first hemodialysis to obtain the influencing factors for the application of AVF at the first hemodialysis. The complications associated with AVF and their influencing factors in the MHD patients were also analyzed. Results In the 198 MHD patients enrolled in this study, the present use of AVF, tunnel-cuffed catheter (TCC) and arteriovenous graft for vascular access were 88.38%, 9.09% and 2.53% respectively, and the use of AVF, TCC and non-cuffed catheter for vascular access at the first hemodialysis were 29.29%, 12.21% and 58.59% respectively. Patients using AVF at the first hemodialysis had higher education level (high school or above high school level; 51.7% vs. 39.3%, P=0.010) and higher proportion with“medical insurance for employees”(82.8% vs. 66.4%, P=0.038), as compared with those using CVC at the first hemodialysis. Multivariate logistic regression showed that the proportion of using AVF at the first hemodialysis was higher in patients with higher education level (OR=3.046, P=0.007) and“medical insurance for employees”( OR=5.128,P=0.007). Serum calcium (F=0.180, P=0.000), phosphorus (F=21.637, P=0.000), albumin (F=0.028, P=0.021) and triglyceride (F=0.665, P=0.024) were higher in MHD patients using AVF for vascular access with complications than those without complications. Conclusion In this cohort of patients, CVC for
vascular access was frequently used at the first hemodialysis, and AVF for vascular access was commonly used at the maintenance hemodialysis period. The better the education level and medical insurance the patients had, the more likely AVF for vascular access at the first hemodialysis they accepted. Higher levels of serum calcium, phosphorus, albumin and triglyceride may be the risk factors for complications in patients using AVF for vascular access.

Key words: Hemodialysis, Vascular access, Arteriovenous fistula, Influencing factor