Abstract: Objective  To investigate calcification of the radial artery (RAC) in arteriovenous fistula (AVF) and its effects on function of the AVF by Doppler ultrasound examination in maintenance hemodialysis (MHD) patients.  Methods  The RAC degree of AVF was evaluated by Doppler ultrasound examination, and the patients were then grouped. The ultrasound parameters for the function of AVF were recorded. Clinical data and quality control of the laboratory results were recruited for statistical analyses. Results  A total of 280 patients were enrolled in this study, and 102 patients (36%) of them had various degrees of RAC in AVF. RAC was negatively correlated with radial artery diameter (r=-0.333, P<0.001) and blood flow in AVF (r=-0.257, P<0.001), but not with short-term AVF dysfunction (r=-0.031, P=0.600). Radial artery diameter (H=38.861, P<0.001) and blood flow in AVF (H=24.035, P<0.001) were significantly different among the groups with different degrees of RAC. The radial artery diameter in patients without RAC was statistically different from that in patients with mild, moderate and severe RAC (Z=37.326, 91.820 and 76.524 respectively; P=0.012, <0.001 and <0.001 respectively); the blood flow in AVF in patients without RAC was statistically different from that in patients with moderate and severe RAC (Z=60.696 and 59.501; P=0.024 and <0.001); the comparisons among other groups had no statistical differences (P>0.05). In patients with RAC, gender (χ2=5.258, P=0.022), age (t=-1.975, P=0.049), dialysis age (Z=3.180, P=0.001), anastomosis method (χ2=7.495, P=0.006), diabetes (χ2=13.252, P<0.001), and serum iPTH level (Z=-2.022, P=0.043) were statistical different from those in patients without RAC. Multivariate logistic regression showed that longer dialysis age (OR=1.010, 95% CI:1.004~1.016, P=0.001), diabetes (OR=3.101, 95% CI:1.713~5.615, P<0.001), and higher serum iPTH (OR=1.002, 95% CI:1.000~1.004, P=0.033) were the independent risk factors for RAC in MHD patients. Conclusion  RAC is unrelated to the short-term AVF dysfunction. When RAC progresses, radial artery diameter becomes smaller and blood flow in AVF decreases. Ultrasound examination has better clinical values in the evaluation of RAC and its degree.

Key words: Hemodialysis, Arteriovenous fistula, Doppler ultrasound, Radial artery calcification