Abstract: Objective To explore the effect of arterial and venous fistula blood flow (AVFB) on the cardiac function and inflammatory response in the elderly patients receiving hemodialysis. Methods A total of 124 elderly patients who underwent hemodialysis with arteriovenous fistulas in our hospital from February 2017 to March 2018 were selected as the study subjects. According to the level of AVFB one month after arteriovenous fistula anastomosis, the patients were divided into high-flow group (>600 mL/min, n=38), medium-flow group (400-600 mL/min, n=45) and low-flow group (<400 mL/min, n=41). All the patients received one year maintenance hemodialysis treatment. The cardiac function, inflammatory response and hemodynamic indexes were detected, and the incidence rates of high-risk events and internal fistula dysfunction were recorded and compared among the three groups. Results Before dialysis, there were no significant differences in cardiac function, inflammatory response and hemodynamic indexes among the three groups (P>0. 05). After dialysis, with the increase of AVFB, the levels of ejection fraction, cardiac output, cardiac index, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, interleukin-6, tumor necrosis factor-α, C-reactive protein, cardiac output, cardiac stroke volume and central blood volume were increased (P<0. 05), but the peripheral vascular resistance was decreased (P<0. 05). The incidence of high-risk events in the high-flow group was significantly higher than that in the low-flow group and medium-flow group (P<0. 05). The incidence rate of fistula dysfunction in the low-flow group was significantly higher than that in the high-flow group and medium-flow group (P<0. 05). Conclusions When the level of AVFB in the elderly patients receiving maintenance hemodialysis is controlled at 400-600 mL/min, the clinical effect is the best.

Key words: maintenance hemodialysis, arteriovenous fistula anastomosis, heart function, inflammation reaction, aged