title: Anticoagulation treatments related different types of vascular access on maintenance hemodialysis patient: A multicenter epidemiological investigation.
abstract: OBJECTIVE
  The objective was to increase the understanding of vascular access in hemodialysis and evaluate hemodialysis-related anticoagulation treatments and the associated hemorrhagic or thrombotic complications.
  
  
  METHODS
  In this study, an epidemiological investigation was conducted in 1175 patients who underwent hemodialysis in seven blood purification centers in northern Chinese. The patients were divided into two groups based on the vascular access they used: Arteriovenous fistula (AVF) group and central venous catheter (CVC) group. The similarities and differences of anticoagulation and hemorrhagic, thrombotic complications were compared between two groups.
  
  
  RESULTS
  Arteriovenous fistula was the most frequently used vascular access, and heparin was the most commonly used anticoagulant. Patients in CVC group experienced significantly greater rates of low molecular weight heparin (LMWH) administration and had a higher rate in achieving thrombotic complications than those in AVF group. There were no significant differences in LMWH dosages in patients with thrombotic complications, as well as the proportion of patients who received anti-platelet drugs. Heparinized catheter lock solutions were excessively high in this study, which may lead to a risk of hemorrhage.
  
  
  CONCLUSIONS
  Hemodialysis-related anticoagulation treatments in China require additional improvements, especially for the patients using CVC as vascular access. There is an urgent need to develop clinical evaluation studies of anticoagulation treatments for achieving more standardized and targeted treatments.
authors.affiliation: National Key Laboratory for Kidney Disease, General Hospital of Chinese PLA, Beijing 100853.
authors.forename: Qi
authors.initials: Q
authors.lastname: Huang
authors.affiliation: National Key Laboratory for Kidney Disease, General Hospital of Chinese PLA, Beijing 100853.
authors.forename: Xue-Feng
authors.initials: XF
authors.lastname: Sun
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province.
authors.forename: Hong-Li
authors.initials: HL
authors.lastname: Lin
authors.affiliation: Department of Nephrology, General Hospital, Beijing 100094.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Harbin Medical University, Beijing 150001, Heilongjiang Province.
authors.forename: Li-Rong
authors.initials: LR
authors.lastname: Hao
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province.
authors.forename: Li
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Ji-Jun
authors.initials: JJ
authors.lastname: Li
authors.affiliation: National Key Laboratory for Kidney Disease, General Hospital of Chinese PLA, Beijing 100853.
authors.forename: De-Long
authors.initials: DL
authors.lastname: Zhao
authors.affiliation: National Key Laboratory for Kidney Disease, General Hospital of Chinese PLA, Beijing 100853.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: National Key Laboratory for Kidney Disease, General Hospital of Chinese PLA, Beijing 100853.
authors.forename: Han-Yu
authors.initials: HY
authors.lastname: Zhu
authors.affiliation: National Key Laboratory for Kidney Disease, General Hospital of Chinese PLA, Beijing 100853.
authors.forename: Xiang-Mei
authors.initials: XM
authors.lastname: Chen
keywords: Anticoagulants; hemodialysis; vascular access