Clinical effect observation on autologous arteriovenous fistula and tunneled cuffed catheter vascular pathways in patients undergoing maintenance hemodialysis
Objective To explore the clinical effect of autologous arteriovenous fistula(AVF)and tunneled cuffed catheter(TCC)vascular pathways in patients undergoing maintenance hemodialysis(MHD).Methods A total of 66 patients undergoing MHD with AVF(AVF group)in PLA Rocket Force Characteristic Medical Center from January 2022 and June 2023 were selected,another 66 patients who underwent MHD with TCC(TCC group)in the same period were selected according to the gender and age.The levels of renal function such as SCr,BUN and β2-microglobulin(β2-MG),PLT activation indicators including PLT α granule membrane glycoprotein(CD62P),lysosomal associated membrane protein 3(CD63),GPⅡb/Ⅲa fibrinogen receptor(PAC-1),and osteoprotegerin(sclerostin),D-dimer(D-D),Dickkopf associated protein 1(DKK-1)and incidence of complications were compared between the two groups before and after six months of treatment.Results Among the 132 patients,85 were males,47 were females,aged from 41 to 76 years,with an average age of(57.0±7.5)years.There were no significant differences in dialysis age,dialysis duration,primary disease,etc.between the two groups(P>0.05).After six months of MHD,the levels of SCr,BUN and β2-MG were decreased in both groups,and there were no significant differences between the two groups(P>0.05).After six months of MHD,the levels of CD62P,CD63,PAC-1,Sclerostin,D-D and DKK-1 were increased in both groups,and the levels of the indicators were lower in AVF group than those in TCC group,with statistical significance(P<0.05).During MHD,the incidence of complications in AVF group was lower than those in TCC group(10.61%vs.22.73%),and the differrences were statistically significant(P<0.05).Conclusions AVF and TCC vascular pathways have the same effect in patients undergoing MHD,however,AVF vascular pathway has fewer effects on PLT activation and vascular calcification after MHD,which can be applied as the first choice for MHD in clinical practice.
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