Abstract: Objectives  To investigate the prevalence of autologous arteriovenous fistula aneurysm (AVFA) and the related clinical symptoms in patients with maintenance hemodialysis (MHD) for ≥3 months in Hainan province in 2020.  Methods  A cross-sectional survey was conducted to investigate the renal primary disease, age, gender, dialysis vintage, AVFA type, maximum diameter and length of the AVFA, and cannulation method in MHD patients using autologous arteriovenous fistula as the vascular access in Hainan province in March 2020. The prevalence of AVFA and the risk factors for AVFA were then derived.  Results   ①The prevalence of AVFA in MHD patients in Hainan province was 41.2%, with the type II AVFA of 54.3% and type III AVFA of 35.1% in the AVFA patients. ②The prevalence of type I AVFA was not correlated with sex, age and AVF puncture method. Patients with hypertension as the primary kidney disease had 3.9 times higher risk of developing type I AVFA than the patients with other primary kidney diseases. The risk of developing type I AVFA increased with increasing dialysis vintage. ③The prevalence of type II AVFAs was not correlated with age and primary kidney disease. Patient with local puncture had the highest prevalence of type II AVFA, being 4.27 times higher than that of buttonhole puncture and 1.73 times higher than that of rope ladder puncture. The risk of developing type II AVFA increased with increasing dialysis vintage; the risk of developing type II AVFA was 1.39 times higher in patient with dialysis vintage of ≥4 years than in patients with dialysis vintage of one year. ④Type III AVFA was relatively complex. The prevalence of type III AVFA correlated with sex, dialysis vintage and AVF puncture method. The risk of developing type III AVFA was 2.55 times higher in patients with other primary kidney disease than in patients with the primary kidney disease of diabetic nephropathy. The risk of developing type III AVFA was 2.11 times higher in young adults than in older patients.  Conclusion  The prevalence of AVFA was 41.2% in MHD patients in Hainan province, with Valentini II and III as the dominant types. Avoiding local puncture can effectively delay the occurrence and development of Valentini II and III AVFAs.

Key words: Maintenance hemodialysis, Autologous arteriovenous fistula, Autologous arteriovenous fistula aneurysm