Abstract: 【Abstract】Objective To study the effects of Gracz arteriovenous fistula (AVF) and indwelling catheter in deep vein on dialysis efficiency, cardiac function and renal anemia in maintenance hemodialysis (MHD) patients and analyze the prognostic factors. Methods A total of 132 MHD patients treated in Xingtai Third Hospital from June 2017 to October 2018 were divided into two groups according to the vascular access method: deep vein indwelling catheter group and Gracz AVF group. Cardiac structure by echocardiography and dialysis related indexes were compared between the two groups. The prognostic factors were analyzed by multivariate Cox proportional risk regression model. Results Kt/V, urea reduction rate (URR) and blood flow in vascular access were higher in Gracz AVF group than in deep vein indwelling catheter group (t=5.478, 3.588 and 3.350 respectively; P＜0.001). After establishment of the vascular access for one year, left ventricular enddiastolic internal diameter (LVDd) and inter-ventricular septum end-diastolic thickness (IVSTd) were significantly higher in Gracz AVF group than in deep vein indwelling catheter group (t=2.997 and 4.477; P=0.003 and ＜0.001); the use of EPO increased significantly in deep vein indwelling catheter group (t= 5.080; P＜0.001), while the concentrations of hemoglobin, prealbumin and albumin increased significantly in Gracz AVF group (t=2.643, 7.177 and 4.838 respectively; P=0.009, <0.001, and <0.001 respectively). Multivariate COX proportional risk regression model showed that ejection fraction (EF) (OR=1.980, 95% CI=1.119～3.502, P=0.019), E/A ratio (OR=1.914, 95%CI=1.046～3.500, P=0.035) and parathyroid hormone (OR=2.065, 95% CI=1.275～3.344, P=0.003) were the prognostic factors for MHD patients. Conclusion Gracz AVF for blood access can affect cardiac structure and cardiac function in MHD patients. Indwelling catheter in deep vein for blood access was less effective in improving renal anemia. Serum parathyroid hormone level and evaluation of cardiac structure by echocardiography are valuable for the estimation of prognosis in MHD patients.

Key words: Arteriovenous fistula, Indwelling catheter in deep vein, Maintenance hemodialysis, Cardiac function, Renal anemia