Abstract: Objective  The purpose of this study was to analyze the effect of temporary central venous catheterization (CVC) on long-term survival of the arteriovenous fistula (AVF).  Methods  We retrospectively collected the general information and laboratory examinations of hemodialysis patients treated in The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine. AVF primary patency time, AVF primary functional patency time, the time from AVF creation to first puncture, and the duration of temporary CVC were recorded. Logistic regression was used to analyze the association between temporary CVC and survival of AVF. Kaplan-Meier survival analysis was used to compare AVF primary patency rate and AVF primary functional patency rate between the CVC group and the non-CVC group, as well as among the three groups of patients with the CVC duration of ≤42 days, 43～89 days, and≥90 days.  Results  A total of 174 patients met the criteria for inclusion in this study. The average age was 58.38±15.35 years old, 57 cases (32.76%) were females, and 68 cases (39.08%) were complicated with diabetes. The time from AVF creation to first puncture, AVF primary patency time and AVF primary functional patency time increased significantly in the non-CVC group, as compared with those in CVC group  (Z= -3.523, -2.064 and -1.965 respectively; P＜0.001, =0.039 and 0.049 respectively). Both univariate binary and multivariate binary logistic regression showed that temporary CVC was associated with AVF survival rate (OR=1.012 and 1.012; 95% CI: 1.000～1.024 and 1.000～1.025; P=0.041 and 0.043). Among the three groups of patients with temporary CVC duration of ≤42 days, 43～89 days, and ≥90 days, AVF primary patency rate and AVF primary functional patency rate were statistically different (χ2=6.354 and 6.926; P=0.042 and 0.031); hemoglobin, hematocrit, urea nitrogen, serum creatinine, the time from AVF creation to first puncture, AVF primary patency time, and AVF primary functional patency time were also statistically different  (F/H=3.222, 5.672, 6.830, 9.366, 49.628, 10.543 and 11.762 respectively; P=0.043, 0.004, 0.001, 0.009, ＜0.001, 0.005 and 0.003 respectively).   Conclusion  This study shows that the time of temporary CVC is correlated to the long-term survival rate of AVF. The long-term survival rate of AVF, AVF primary patency time, and AVF primary functional patency were higher and longer in the group with temporary CVC time ≤42 days. Therefore, temporary CVC should be removed as early as possible when conditions permit.

Key words: Temporary central venous catheter, Arteriovenous fistula, Survival rate