Abstract: 【Abstract】Objective To explore the effect of different dialysis blood flow on complications of internal fistula in hemodialysis patients. Methods Forty patients undergoing autologous arteriovenous fistula (AVF) surgery for the first time and 40 patients using AVF for routine hemodialysis in The Second Affiliated Hospital of Wenzhou Medical University from January to March 2019 were enrolled in this study. Patients with new AVFs were randomly divided into model group (n=20) and control group (n=20). In model group, the dialysis blood flow was 160～200 ml/min at the beginning and increased to 220-250 ml/min after one month. In control
group, the dialysis blood flow was initially 220～250 ml/min and increased to 280～310 ml/min after one month. Patients with mature AVFs were also randomly divided into model group (n=20) and control group (n=20). The dialysis blood flow was 220～250 ml/min in model group and was 280～310 ml/min in control group. All patients were dialyzed 3 times a week for 12 months. Dysfunction and complications of the AVFs were observed, related biochemical indicators were assayed, and dialysis sufficiency was evaluated in these groups. Results Dysfunction and complications of the AVFs were significantly reduced in the two model
groups. In patients with new AVFs, the rate of AVF complications was significantly lower in model group than in control group (χ2=6.465, P=0.011). In patients with mature AVFs, the rates of AVF dysfunction (χ2=3.135, P=0.077) and AVF complications (χ2=3.135, P=0.077) had no differences between model group and control group. In patients with new AVFs and with mature AVFs, dialysis sufficiency was lower in model groups than in their respective control groups, but without statistical significance (Fisher exact analyses, P=0.451 and 0.407). Conclusion Reduction of dialysis blood flow can decrease the presence of AVF complications and improve the prognosis of AVF, without significant impact on dialysis sufficiency.

Key words: Dialysis blood flow, Autogenous arteriovenous fistula, Hemodialysis, Internal fistula complication