The application status of vascular access in patients with end stage renal disease in first time hemodialysis

CHEN Guanfen; XIN Liqin; YANG Lihua

doi:10.3969/j.issn.1002-7386.2016.17.005

Abstract：Objective To investigate the application status of vascular access in patients with end stage renal disease (ESRD) in first time hemodialysis (HD) in order to provide scientific basis for selecting suitable vascular access in HD. Methods The clinical data, selected vascular access types during first time HD in patients with ESRD in Qujing Second People’ s Hospital of Qujing City of Yunnan Province from October 2011 to December 2013 were retrospectively analyzed,with follow-up for 6 months to analyze the outcome of vascular access and the changes of therapeutic schedule. Results A total of 365 patients were enrolled in the study,in whom 225 cases were males and 140 cases were females,with average age being 51.65 ±18. 45 years. The main pathological causes were primary glomerulopathy (71. 23%), next,diabetic nephropathy (10. 96%). In first time HD most patients (84. 93%) selected central venous catheter (CVC),only a few patients (15. 07%) selected arteriovenous fistula (AVF) as hemodialysis blood vessel. However after 6-month follow-up, among 340 patients, 245 patients ( 72. 06%) selected AVF as permanent vascular access, 21 patients ( 6. 17%) received renal transplant and the other 28 patients ( 8. 24%) received peritoneal dialysis. The Logistic regression analysis showed that males,the patients coming from the other region instead of Qujing and the patients whose glomerular filtration rate ( GFR) was lower than 5 ml · min-1 · ( 1. 73 m2 ) -1 were the risk factors of selecting central venous catheters in first time HD. Conclusion Only a minority of patients select AVF in first time HD, through the cooperation of hospital aspect and patients with their families, majority of patients select finally AVF as HD access to ensure continuing performance of HD.