Effect Of Serum ADMA And HDF On Calcification Of Cephalic Vein Of Internal Fistula In Patients With Maintenance Hemodialysis

Objective: To explore the effects of serum ADMA level,different HDF frequencies and modes,blood calcium,blood phosphorus,dialysis age,and blood pressure on the cephalic vein calcification at the vascular site of the maintenance hemodialysis internal fistula,and to analyze the relationship between them and the cephalic vein calcification at the vascular site of the internal fistula.Methods: A total of 84 patients with maintenance hemodialysis during the period of 2018.12-2019.12 in the Department of Nephrology and Hemodialysis of the Second Affiliated Hospital of Chongqing Medical University were selected.detect dry weight,blood pressure,total cholesterol,creatinine,uric acid,iPTH,triglyceride,low density lipoprotein cholesterol(hdl-c),indices such as hemoglobin,serum ADMA levels using competitive inhibition enzyme-linked immunosorbent assay(ELISA).Color Doppler Ultrasound assessment of calcification of the head vein in patients with MHD.84 patients were divided into two groups A and B according to different hemodialysis frequencies.Group A(HD + HDFQW / PHFQW)51 cases,group B(HD + HDFQM / PHFQM)33 cases;group A 51 patients based on different hemodialysis Methods were divided into subgroups A1,A2,30 patients in group A1(HD + PHFQW),21 patients in group A2(HD + HDFQW);33 patients in group B were divided into subgroups B1,B2 according to different hemodialysis methods.There were 13 cases in group B1(HD + PHFQM)and 20 cases in group B2(HD + HDFQM),and the results were analyzed.Results: After statistical analysis of the included cases,it was concluded that the comparison between groups showed that those with high hemodiafiltration frequency had stronger ability to clear serum ADMA than those with low hemodialysis frequency,and the difference was statistically significant(P<0.05).But there was no significant difference in the effects of HDF and PHF on blood calcium,blood phosphorus,ADMA and cephalic vein calcification in ESRD maintenance hemodialysis patients.Analysis of factors related to cephalic vein calcification showed that calcification was strongly positively correlated with dialysis age(P= 0.0r = 0.61),weakly negatively correlated with diastolic blood pressure(P= 0.025 r =-0.245),weakly negatively correlated with total cholesterol(P= 0.029 r =-0.238),and weakly positively correlated with blood calcium(P= 0.027 r = 0.241).Therefore,patients with cephalic vein calcification had longer dialysis age,lower diastolic blood pressure,lower total cholesterol,and higher blood calcium.Cephalic vein calcification was related to long dialysis age and low diastolic blood pressure.Conclusion:1.There was no significant correlation between serum ADMA level and cephalic vein calcification at AVF in MHD patients2.There was no significant correlation between HDF/PHF frequency and cephalic vein calcification at AVF in MHD patients3.The higher the frequency of HDF/PHF,the stronger the ability to clear ADMA4.Low diastolic blood pressure and long dialysis age are risk factors for cephalic vein calcification at AVF in MHD patients...