Abstract: Objective  To investigate the status of vascular access in maintenance hemodialysis (MHD) patients in primary hospitals.  Methods  This was a multi-center and cross-sectional study, which collected clinical data of the MHD patients in the hemodialysis centers of 15 primary hospitals located in 8 regions in Jiangsu and Anhui provinces from March 2023 to August 2023.  Results  A total of 650 MHD patients who met the criteria were investigated, including 342 males (52.62%) and 308 females (47.38%) with a median dialysis age of 5.48 (2.00, 8.00) years. For blood access of the first hemodialysis, non-cuffed catheter was used in 291 cases (48.10%), and autologous arteriovenous fistula (AVF) was used in 271 cases (44.79%). For current blood access of hemodialysis, autologous AVF was used in 518 cases (85.62%); rope ladder puncture technique on the AVF was used in 100 cases (19.30%), and regional puncture technique was used in 412 cases (79.54%). For blood access in patients with arteriovenous graft, rope ladder puncture technique on the graft was used in 29 cases (90.63%). Vascular stenosis, the main complication of vascular access, occurred in 177 cases (34.17%) in patients with autologous AVF and in 10 cases (31.25%) in those with arteriovenous graft.  Conclusion  The status of vascular access in MHD patients in the hemodialysis centers in primary hospitals meets the expectations of primary hospitals. However, performance of blood access should be further standardized, and personnel training should be reinforced to find out and manage vascular stenosis earlier.

Key words: Hemodialysis, Vascular access, Cannulation, Complication