The Influences Of Different Vascular Assesses On Inflammatoyry Status In Maintenance Hemodialysis Patients

Objective: To investigate the influence of different vascular accesses on C-reactive protein(CRP)level and microinflammatory state in maintenance hemodialysis(MHD)patients.Methods: 220 patients with MHD were enrolled in the cross sectional study.The projects were divided into two groups according to the MHD vascular access,including 138 cases in arteriovenous fistula(AVF)group and 83 cases in tunneled cuffed catheter(TCC)group.There were 93 males and 45 females in AVF group,the average age was(51.7 ± 14.2)years old,While 54 males and 28 females in TCC group,and the average age was(60.4 ± 15.4)years old.Serum high sensitivity C-reactive protein(hs-CRP),albumin,total calcium,phosphorus,intact parathyroid hormone,the urea nitrogen,creatinine,uric acid,serum ferritin and transferrin saturation before and after dialysis were detected,and then calculated the calcium and phosphorus product,Kt / v,URR toinvestigate the influence of different vascular access on serum hs-CRP.Results: The hs-CRP in TCC group was significantly higher than that in AVF group,and the difference was statistically significant(P <0.05).There were significant differences in age,albumin and creatinine between the two groups(P<0.05).Albumin,transferrin saturation were negatively correlated to hs-CRP(r=-0.182,r =-0.187,P = 0.007,P = 0.005).Uric acid was positively correlated to hs-CRP and it was statistically significant(r = 0.188,P = 0.005).Multivariate stepwise regression analysis indicated that vascular access was the independent influenced factor for hs-CRP(F = 26.238,P <0.001).Conclusion: Different vascular accesses can influence the level of serum CRP in MHD patients,tunneled cuffed catheter can be one of the causes of microinflammatory status in MHD patients.