Comparison of the Effect of Different Parts of Arteriovenous Fistula on He-modialysis in Elderly Diabetic Nephropathy Patients with Uremia
Objective To compare and analyze the effect of different parts of arteriovenous fistula on hemodialysis in elderly diabetic nephropathy patients with uremia.Methods 78 elderly diabetic nephropathy uremia patients treated in the Affiliated People's Hospital of Jiangsu University from June 2019 to February 2023 were selected and divided into three groups according to different locations of arteriovenous fistula,namely,low internal fistula group(n=26),middle internal fistula group(n=26)and high internal fistula group(n=26).The low internal fistula group had internal fistula at 2-3 cm above the wrist stripes,the middle internal fistula group had internal fistula at 2-3 cm below the midpoint of the cubital stripes,and the high internal fistula group had internal fistula at about 2 cm above the cubital stripes.The dialysis adequacy,anemia status and complications of the three groups were observed and compared.Results The urea nitrogen clearance rate,urea nitrogen decline rate and blood flow through vascular access in the low internal fistula group were significantly lower than those in the middle internal fistula group,and the urea nitrogen clearance rate,urea nitrogen decline rate and blood flow through vascular access in the middle internal fistula group were significantly lower than those in the high internal fistula group,the differences were statistically significant(all P<0.05).The levels of hemoglobin,ferritin and albumin in the low internal fistula group were significantly lower than those in the middle internal fistula group,and the levels of hemoglobin,ferritin and albumin in the middle internal fis-tula group were significantly lower than those in the high internal fistula group,the differences were statistically sig-nificant(all P<0.05).The decibels of complication incidence in the low internal fistula group and the middle internal fistula group were 3.85%and 7.69%,which were significantly lower than 30.77%in the high internal fistula group,and the differences were statistically significant(both P<0.05).Conclusion In the hemodialysis treatment of elderly diabetic nephropathy patients with uremia,the dialysis adequacy of high arteriovenous fistula is higher,and it can ef-fectively improve the anemia state,but the complication rate is higher.
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