Effect of autologous arteriovenous fistula and long-term indwelling of deep venous catheter on the hemodialysis, cardiac function and renal anemia in MHD patients

ObjectiveTo study the effects of autologous arteriovenous fistula and long-term indwelling of deep venous catheter on the hemodialysis, cardiac function and renal anemia in maintenance hemodialysis(MHD)patients.

MethodsOne hundred and twenty patients with MHD were randomly divided into the observation group and control group(60 cases in each group).The observation group was treated with autologous arteriovenous fistula for MHD, while the control group was treated with long-term indwelling of deep venous catheter.The therapeutic effects, dialysis adequacy, cardiac function, renal function, inflammatory reaction and complications were compared between two groups.

ResultsThe total effective rate in observation group(83.33%)was significantly higher than that in control group(66.67%)(P < 0.01), and the hemodialysis adequacy in observation group(1.68±0.36)g/kg was significantly higher than that in control group(1.26±0.21)g/kg(P < 0.01).The differences of the hemoglobin, glomerular filtration rate, left ventricular ejection fraction(LVEF), anterior and posterior left atrial diameter(LAD), right ventricular inner diameter(RVD), left ventricular end-diastolic volume(LVEDV), and inflammatory factor levels between two groups before treatment were not statistically significant(P>0.05).After treatment, the hemoglobin and glomerular filtration rate in observation group were significantly higher than those in control group(P < 0.01).Compared with before treatment, the levels of LAD and LVEDV significantly increased, and the LVEF level significantly decreased in two groups after treatment(P < 0.05 to P < 0.01).After treatment, the level of LVEF in observation group was higher than that in control group, while the levels of LAD, RVD and LVEDV in observation group were lower than those in control group (P < 0.01).After treatment, the levels of TNF-α, IL-6 and IL-8 in two groups significantly decreased compared with before treatment(P < 0.01), and the above parameters in observation group were significantly lower than those in control group(P < 0.01).The differences of the incidence rates of infection and renal anemia between two groups were not statistically significant(P>0.05), and the cardiovascular events in observation group was significantly lower than that in control group(P < 0.05).

ConclusionsCompared with the long-term indwelling of deep venous catheter, the effects of autologous arteriovenous fistula on dialysis in MHD patients is better, wich has less impact on cardiac function, and is worthy of promotion in clinic.