Effects Of Tunneled Polyester Sheath Catheter And Autologous Arteriovenous Fistula Vascular Access On Micro-inflammation And Cardiovascular Events In Maintenance Hemodialysis Patients

Objective:To explore the effects of tunneled polyester sheath catheter and autogenous arteriovenous fistula vascular access on micro-inflammation and cardiovascular events in maintenance hemodialysis patients.Methods:The patients who received maintenance hemodialysis from 2019 to June were retrospectively included as the research subjects.Basic information such as gender,age,dialysis age,and primary disease of the patients were collected.HS-CRP,HB,WBC and other biochemical data of patients were also collected.The NLR,PLR,Kt/V and URR were calculated.Events such as heart failure,arrhythmia,and cardiovascular death within one year were recorded.Proper parameter tests and non-parametric tests were used to explore the differences of the above parameters between the two;curve fitting was used to preliminarily analyze the relationship between NLR,PLR and HS-CRP;logistic regression was used to analyze the incidence of the cardiovascular events between the two after controlling the confounding factors.Results:A total of 103 patients were finally included,of which 25 patients used tunneled polyester sheath catheter as vascular access,with an average age of 51.4±9.7 years old,and 78 patients used an autologous arteriovenous fistula as vascular access with an average age of 48.6±12.6 years old.The median dialysis age in the catheter group was lower than that in the fistula group(68 months vs 102 months,P=0.005).No significant difference in other general conditions or biochemical variables between the two groups was detected.Compared with the fistula group,the catheter group had higher levels of micro-inflammatory indicators such as HS-CRP(5.1 vs 4.0,P=0.019),NLR(3.9 vs 4.9,P=0.039),and no statistical difference was detected in PLR between the two.Compared with the fistula group,the catheter group had a higher incidence of heart failure(32.0%vs 12.8%,P=0.019)and arrhythmia(40.0%vs 19.2%,P=0.039).No significant difference was detected in the incidence of cardiovascular death between the two.Conclusion:Compared with the fistula group,the catheter group has higher levels of micro-inflammation and a higher risk of developing heart failure and arrhythmia,but no significant difference was detected in the risk of cardiovascular death rate between the two.