Veno-venous Puncture: A New Alternative Method Of Vascular Access On Hemodialysis

Objective To investigate the feasibility of veno-venous puncture(VVP) as temporary and long-term vascular access in hemodialysis patients.Methods There were two parts in this study: temporary vascular access and long-term vascular access. Part 1. Temporary vascular access: A total of 66 incident hemodialysis patients were enrolled in this study in Department of Blood Purification, Fuzhou General Hospital of Nanjing Military Command during the period from Jun 2014 to Jun 2015.They were randomly divided into VVP group(n=33) and Tunneled cuffed catheter(TCC) group(n=33). The dialysis adequate, access recirculation rate and access complications were compared between two groups. Part 2. Long-term vascular access: A total of 56 maintenance hemodialysis patients were enrolled in this study in Department of Blood Purification, Fuzhou General Hospital of Nanjing Military Command during the period from Jun 2014 to Jun 2015.They were divided into VVP group(n=28) and AVF group(n=28). The Dialysis adequate, access recirculation rate and access complications between two groups were compared.Results Part 1. Temporary vascular access: There were no significant differences in demographic characteristics and laboratory data between two groups when recruited(P>0.05). After 2 months follow-up, access dysfunction rate in VVP group was lower than in TCC groups(?2=4.181, P=0.041), while access recirculation rate, access-related infection rate and dialysis adequate were not significant different between two groups(P>0.05). Part 2. Long-term vascular access: There were no significant differences in demographic characteristics and laboratory data between two groups when recruited(P>0.05). After 6 months follow-up, access recirculation rate in VVP group was lower than in AVF groups(?2=4.403, P=0.036), while access dysfunction rate, access-related infection rate and dialysis adequate were not significant different between two groups(P>0.05).Conclusion Compared to AVF and TCC, VVP has similar dialysis adequate, less access complications and access recirculation. For patients with more than 5mm of median cubital vein diameter, VVP might be an alternative choice of incident hemodialysis vascular access or of long-term hemodialysis vascular access especially when AVF cannot be created and TCC cannot be placed either.