Veno-venous puncture: A new alternative method of vascular access on hemodialysis / 第二军医大学学报

ABSTRACT

Objective To investigate the feasibility of veno-venous puncture (VVP) as an alternative for temporary and long-term vascular access in hemodialysis patients. Methods A total of 84 hemodialysis patients were enrolled in this study in Fuzhou General Hospital, PLA Nanjing Military Area Command between June 2014 and June 2015. The priority order of vascular access is as follow arteriovenous fistula (AVF)-, tunneled cuffed catheter (TCC), and VVP. Patients were divided into VVP group (n=28), TCC group (n=28) and AVF group (n=28). Dialysis adequacy, access recirculation rate and access complications were observed and compared among each group for a follow-up of 6 months. Results There were no significant differences in spKt/V. eKt/V or urea reduction ratio (URR) among the three groups at 0, 3 and 6 months after dialysis. After 6 months, the access recirculation rate in VVP group was significanlty lower than that in the other two groups (0 vs 14. 28%, 21. 43%; P<0. 05), and access dysfunction rate in VVP group was also significantly lower than that in TCC group (0 vs 21. 43%, P<0. 05), while the access-related infection rates were not significantly different among three groups. Conclusion VVP is easy to perform, with less complications and low access recirculation rate, and it might be an alternative choice for hemodialysis when AVF cannot be created or TCC cannot be placed.