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The patients enrolled are limited.
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The investigators hypothesis that aneurysms and stenoses will be decreased if the direction of inserted arterial needle were same as the direction of blood flow, when compared to the opposite direction puncture.
Native arteriovenous fistula (AVF) is the preferred access for hemodialysis, and cannulation technique is very important factors affect the outcomes of AVF. Rope-ladder cannulation is one kind of the standard puncture techniques which is used commonly in maintenance hemodialysis (MHD) patients. There are many complications for rope-ladder cannulation, such as venous aneurysm and vascular stenosis, which may induce AVF dysfunction. For the venous outflow way, there always be aneurysm followed by stenoses at the sites of needle connected with the arterial line in rope-ladder cannulation patients. The investigators hypothesis that the directions of inserted arterial needles should affect the AVF outcomes. The present prospective study will compare the outcomes of AVF between the puncture direction at arterial needle sites same as blood flow and opposite to blood flow.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Same direction cannulation | Experimental | The inserted direction of arterial needle is same as the direction of blood flow. |
|
| Opposite direction cannulation | Active Comparator | The inserted direction of arterial needle is opposite to the direction of blood flow. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Same direction cannulation | Other | The puncture direction of the arterial needle is same as the blood flow in every hemodialysis session. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of AVF aneurysm and stenosis. | Compare the prevalence of AVF aneurysm and stenosis between two groups during 12 months. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Proportions of AVF dysfunction in different groups. | Compare the proportions of AVF dysfunction between two groups during 12 months. | 12 months |
| The size of venous aneurysm. | Measure the maximum size of venous aneurysm by using ultrasonography at month 12. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dongliang Zhang, Doctor | Kidney Disease Faculty of Capital Medical University | Study Chair |
| Wenying Cui, Bachelor | Nephrology Department of Beijing Friendship Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Friedship Hospital | Beijing | Beijing Municipality | 100050 | China |
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| ID | Term |
|---|---|
| D001164 | Arteriovenous Fistula |
| D000783 | Aneurysm |
| ID | Term |
|---|---|
| D001165 | Arteriovenous Malformations |
| D054079 | Vascular Malformations |
| D018376 | Cardiovascular Abnormalities |
| D002318 | Cardiovascular Diseases |
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| Opposite direction cannulation | Other | The puncture direction of the arterial needle is opposite to the blood flow in every hemodialysis session. |
|
| 12 months |
| Diameter of venous stenosis. | Measure the minimum diameter of venous stenosis by ultrasonography at month 12. | 12 months |
| Percentages of unsuccessful cannulations. | Unsuccessful cannulations include mis-cannulation, cannulation ease, hematoma, more than once cannulation at arterial site. | 12 months |
| Events of AVF obstruction. | AVF obstruction and the following treatments as central venous catheters and interventions will be recorded and compared between two groups during 12 months. | 12 months |
| D016157 | Vascular Fistula |
| D014652 | Vascular Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D005402 | Fistula |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |