Abstract
Background Chronic kidney disease has become a serious public health problem in China. Our study
is to explore effect of hydraulic expansion on arteriovenous fistula (AVF) of hemodialysis
patients.
Methods A total of 190 patients with end-stage renal disease (ESRD) were randomly divided
into hydraulic expansion group (n = 117) and conventional surgery group (n = 73). Age, sex, the cause of ESRD, height, weight, body mass index (BMI), blood
pressure, and diameter of artery and vein from ultrasonography before surgery from
patients were recorded. Doppler ultrasonography of vessel was performed with a 12-MHz
scanning probe for vascular measurements. The time of first cannulation was recorded.
Primary and secondary patency rates were compared between the two groups.
Results The mean arterial pressure for this cohort of patients was around 98.12 mm Hg. The
mean diameters of artery and vein ready for anastomoses measured by ultrasonography
before surgery were 1.96 and 2.04 mm, respectively. Age, weight, BMI, sex ratio, the
cause of renal failure, history of catheter insertion, mean arterial pressure, frequency
of hemodialysis, blood flow of hemodialysis, and the mode of anastomoses of AVF in
conventional surgery group were similar to hydraulic expansion group. There were no
differences in stroke volume of radius arterial and venous pressure before dilation
between the two groups. The stroke volume of radius artery increased significantly
after hydraulic expansion than before dilation and control group. The primary patency
rates of AVF in patients with hydraulic expansion were higher significantly than conventional
surgery group. The secondary patency rates in conventional surgery group were not
different from hydraulic expansion group.
Conclusion Hydraulic expansion showed no difference from conventional surgery in complication
after operation, and could decrease the time reliance on catheters and the risk of
catheter-related infection, thrombosis, and decrease the related medical care costs.
Keywords
hydraulic expansion - arteriovenous fistula - hemodialysis - end-stage renal disease
- patency rate
