Abstract: Objective To investigate the relationship between procalcitonin (PCT) and complications of autogenous arteriovenous fistula (AVF) in patients with maintenance hemodialysis (MHD). Methods A total of 186 patients treated with AVF for MHD were selected. According to whether the complications [stenosis and/or thrombosis] of AVF were detected by ultrasound during the follow-up, 48 cases were divided into the complication group and 138 cases were divided into the non-complication group. Clinical data of patients in the two groups were collected, including dialysis age, the number of patients with systolic blood pressure decline ≥30 mmHg (1 mmHg=0.133 kPa), the number of patients with puncture failure or hematoma formation, and the number of patients with diabetes. PCT, C-reactive protein (CRP) and platelets (Plt) were also detected. The indicators were compared between the two groups. Binary Logistic regression analysis was performed to analyze the related influencing factors of AVF complications. Results The incidence of diabetes mellitus, systolic blood pressure drop ≥30 mmHg, puncture failure or hematoma formation, PCT, CRP, dialysis age were significantly higher in the complication group than that in the non-complication group (P＜0.05). There were no significant differences in gender, age, primary disease, Kt/V, BMI, monthly hemoperfusion and hemodiafiltration time between the two groups (P＞0.05). Logistic regression analysis showed that higher levels of PCT, systolic blood pressure drop≥30 mmHg, puncture failure or hematoma formation in hemodialysis were the risk factors for the complications of AVF (P＜0.05). Conclusion High level PCT is an independent risk factor for AVF complications in MHD patients. Clinical attention should be paid to the improvement of microinflammation, reasonable control of blood pressure to avoid rapid decline in hemodialysis and continuous improvement of puncture technique.

Key words: renal dialysis, arteriovenous fistula, calcitonin, complications、 thrombosis, vascular stenosis