Abstract: Objective  To explore the application of novel single-needle puncture technique for safe puncture in the maintenance hemodialysis (MHD) patients with complex autologous arteriovenous fistulas (AVF).   Methods   A total of 42 MHD patients undergoing regular hemodialysis in the Department of Nephrology, Beijing Haidian Hospital (Peking University Third Hospital Haidian District Section) between May 2023 and May 2024 were enrolled in this study. They were divided by random table method into observation group (using single-needle technique for hemodialysis) and control group (using traditional puncture method for hemodialysis). Puncture related data were compared between the two groups.   Results   There were no statistical differences in baseline data, including age, gender, primary disease, the status of complex AVF (initial fistula, acute thrombosis secondary to stenosis, and difficulties in puncture) and central venous indwelling catheter, between the two groups at the time of enrollment (P >0.05). The total number of punctures was 43 in observation group, lower than that of 81 times in control group, with the average number of punctures statistically lower in observation group than in control group (t =8.446, P >0.001). The incidence of puncture injury was statistically lower in observation group than in control group (c2=9.860, P=0.007). The rate of indwelling catheter usage was statistically lower in observation group than in control group (c2=16.800, P <0.001). The average value of online real-time Kt/V monitoring was statistically lower in observation group than in control group (t =-3.594, P=0.001).   Conclusion  The novel single-needle puncture technique can effectively reduce the number of punctures, the complications caused by multiple needle punctures, and the rate of central venous catheter usage, and ensure safe puncture to the complex AVF during its difficult puncture period. Therefore, this method is worthy of clinical promotion.

Key words: Single-needle puncture for hemodialysis, Novel single-needle puncture technique, Maintenance hemodialysis patient, Complex autologous arteriovenous fistula, Safe puncture