超声稀释法在血液透析血管通路功能评价中的初步应用

目的：探讨超声稀释法在血液透析血管通路功能评估中的临床应用价值,并观察血管通路血流量与患者心输出量的相关性。方法：选择在我院血液净化中心透析龄为3～6月的维持性血液透析患者82例,病情稳定,已排除急性活动性疾病,均采用自体动静脉内瘘作为血管通路。使用Transonic HD02型血液透析监护仪对患者的血管通路进行检测,随访期为6个月,分别监测内瘘再循环率、内瘘通路血流量及心输出量等,并观察血管通路血流量与患者心输出量的相关性。结果：（1）观察0个月,内瘘血流量平均为（994.41±434.98）ml/min,心输出量平均为（6.38±3.14）L/min;随访6个月后复测相关指标,血液透析患者的血管通路血流量和心输出量均有所下降,内瘘血流量平均为（961.19±420.92）ml/min,心输出量平均为（6.12±4.17）L/min,但观察6个月与0个月比较,无统计学差异（P〉0.05）;4例（4.88%）患者出现再循环,均大于5%。（2）观察0个月,血管通路狭窄的发生率为9.76%;观察6个月后,血管通路狭窄的发生率为26.83%,二者比较,血管通路狭窄的发生率有统计学差异（P〈0.05）。（3）血管通路血流量与心输出量呈正相关（P〈0.05）,提示患者低心输出量可能导致血管通路血流量的下降。结论：超声稀释法操作简便、非创伤侵入性、安全实用,适用于血液透析患者血管通路的功能评估,可以前瞻性监测血管通路血流动力学意义上的狭窄,具有临床应用价值。     

血液透析患者动静脉内瘘栓塞及影响因素研究

目的探讨血液透析患者动静脉内瘘栓塞的影响因素。方法选取72例建立自体动静脉内瘘患者,应用超声稀释技术在入组2周内及3、6个月后对自体动静脉内瘘栓塞相关指标进行3次监测,然后随访观察6个月(共观察1年)。观察期间记录动静脉内瘘栓塞发生情况以及流量和再循环率的变化趋势,同时收集患者性别、年龄、内瘘使用时间、透析龄、平均动脉压、糖尿病病史、钙磷乘积、心输出量等资料。结果随访结束时18例发生栓塞,栓塞发生率为25.0%;18例3次监测的平均内瘘流量为(709.6±337.8)mL/min,其中13例第1次监测时内瘘流量500mL/min;第1次监测内瘘存在再循环的5例患者均发生栓塞。未发生栓塞的54例患者3次监测的内瘘流量为(1 171.7±692.9)mL/min,仅9例第1次监测时内瘘流量500mL/min。Logistic回归分析结果显示,再循环率、内瘘流量、钙磷乘积、糖尿病病史、心输出量是动静脉内瘘栓塞的影响因素(P0.05,P0.01)。结论定期监测血液透析患者动静脉内瘘栓塞相关指标,对内瘘栓塞的影响因素进行早期干预可防范内瘘栓塞的发生,延长内瘘使用寿命。     

超声稀释法监测血液透析患者的内瘘功能

目的对维持性血液透析患者进行内瘘血流量（Qb）及再循环率（R％）测定，了解血液透析患者的内瘘功能状态。方法在患者血液透析开始后30min及结束前1h采用超声稀释法测定内瘘功能。对内瘘血流量过低（Qb〈600ml／min）及过高（Qb〉1800ml／min）的患者进行彩色多普勒超声检查。测量内瘘头静脉内径、桡动脉内径、肱动脉内径及平均血流速度并排除血管腔有无狭窄。结果180例患者中的163例成功进行了内瘘功能测定，3例再循环率〉0，占0．02％。平均Qb（1010．3±662．6）ml／min，40例Qb〈600ml／min（24．5％，低流量组），104例Qb为600-1800ml／min（63.8％，正常流量组），19例Qb〉1800ml／min（11．7％，高流量组）。多普勒超声检查低流量组10例，高流量组7例。两组比较在头静脉内径、桡动脉内径、流速、肱动脉流速方面差异均有统计学意义。结论超声稀释法评定血管内瘘功能有较好的敏感性和特异性，是血管通路（包括自身血管和人造血管）功能监测的一种良好的手段。     

无创心输出量监测在心力衰竭患者循环支持时的应用

背景尽管肺动脉导管（PAC）热稀释法的有效性、安全性均存在问题且使用困难，然而该方法目前在围手术期心外科重症监护室中仍普遍被应用于对中心血流动力学的监测和管理。超声心输出量监测仪（USCOM）是一种无创性连续多普勒装置，用于直接测量心输出量（CO），可替代PAC。虽然USCOM的可靠性存在一些公认的局限性，但已证实该方法比PAC在心外科重症监护室更具主导地位。我们比较了心力衰竭（HF）患者在应用一种原位全人工心脏（TAH）控制治疗期间，USCOM与CardioWest的心输出量测量结果。方法选择安装全人工心脏的心力衰竭（TAHHF）患者，按照盲法使用CardioWest和USCOM设备监测患者心输出量（CO）、每搏心输出量（SV）和心率（HR）。根据CardioWest所控制流量的不同，监测7例患者18个不同时点，获得了508对测量结果。用Bland—Altman分析法比较一致性。结果使用CardioWest和USCOM设备测得患者的心输出量、每搏心输出量和心率的平均值和标准差（±标准差）分别是7．33±0．46和7．34±0．51L/min、56．2±3．8和56．6±3．8ml，以及131±3和130±4bpm。心输出量的范围为5．2，9．3L／min。两种方法检测的心输出量、每搏心输出量和心率的平均差值分别是-0．01±0．23L／min、-0．34±1．97ml和0．9±2．3bpm，平均百分比差为一0．3％、-0．6％和0．7％。心输出量、每搏心输出量和心率一致性的百分比范围分别为6．4％、7．1％和3．6％。结论USCOM对于安装全人工心脏的心力衰竭患者的心输出量无创性监测和管理不失为一个可行且准确的方法，其可能在心血管疾病的诊断和治疗中有更广泛的应用。     

超声稀释法在带隧道带涤纶套导管患者中的临床应用

目的探讨超声稀释法(ultrasound dilution,UD)在带隧道带涤纶套导管(tunneled cuffed catheter,TCC)的血液透析(hemodialysis,HD)患者血管通路维护中的临床应用价值。方法纳入2015年1月至2016年2月在华西医院血液透析中心使用TCC作为血管通路规律维持性透析6个月以上,并利用HD02血液透析监测仪行UD评估血管通路的HD患者。记录所有TCC患者循环率(access recirculation,AR)及实际血流量。评估UD方法在TCC再循环率危险因素分析等方面的应用。采用卡方检验比较组间差别,同时进一步采用Logistic多因素回归分析探讨基于HD02监测的TCC患者再循环率的影响因素。结果共纳入TCC患者78例,UD监测分析显示:(1)组间比较结果提示,相比导管反接,导管正接的AR较低,差异有统计学意义[0%(0%～4%)vs. 34%(14%～42%),P0.01]。(2)多元Logistic回归分析提示,TCC患者导管反接与AR独立相关[OR=14.754,95%CI(3.689～59.013)],而透析龄、TCC建立时间、糖尿病因素与AR的关联在多元回归分析中差异无统计学意义(P0.05)。结论导管反接是引起TCC患者AR的危险因素。基于UD的血管通路监测有助于及时发现血管通路障碍,在HD患者血管通路维护中具有临床应用价值,下一步拟前瞻性队列研究进一步验证本研究结果。     

永久性双腔血液透析导管流量及再循环率的测定

目的了解不同型号永久性双腔血液透析留置导管的实际流量以及不同流量和连接方法下导管再循环率的情况,为永久性双腔导管的临床应用提供实证依据。方法将56例使用永久性双腔血液透析导管的血液透析患者根据留置导管不同分为Perm-cath组(P组)30例,Tal Palindrome TM组(T组)26例,利用Transonic HD02血液透析监护仪进行实际血流量监测。测定正接和反接状态下,泵设流量分别为150、200、250、300、350mL/min时的再循环率。结果无论正接还是反接,两组实际流量均能达到泵设流量的要求;不同泵设流量时正接和反接实际流量比较,差异无统计学意义(均P>0.05)。正接时泵设流量150～350mL/min,两组几乎没有再循环。反接时,不同泵设流量组内再循环率比较,差异无统计学意义(均P>0.05);但各不同泵设流量下,P组再循环率显著高于T组(均P<0.01)。结论两种永久性双腔血液透析留置导管血流量能满足泵设流量需求,正接时都没有再循环;反接时Tal Palindrome TM型再循环率比Permcath型低,两种导管再循环率不随泵设流量的增加而增加。因此,应尽量避免反接导管,必须反接时,可相应提高血流量,以保证透析效果。     

Measurement of blood flow and access recirculation of permanent dual-lumen catheters in hemodialysis patients

目的 了解不同型号永久性双腔血液透析留置导管的实际流量以及不同流量和连接方法下导管再循环率的情况,为永久性双腔导管的临床应用提供实证依据.方法 将56例使用永久性双腔血液透析导管的血液透析患者根据留置导管不同分为Perm-cath组(P组)30例,Tal Palindrome TM组(T组)26例,利用Transonic HD02血液透析监护仪进行实际血流量监测.测定正接和反接状态下,泵设流量分别为150、200、250、300、350 mL/min时的再循环率.结果 无论正接还是反接,两组实际流量均能达到泵设流量的要求;不同泵设流量时正接和反接实际流量比较,差异无统计学意义(均P＞0.05).正接时泵设流量150～350 mL/min,两组几乎没有再循环.反接时,不同泵设流量组内再循环率比较,差异无统计学意义(均P＞0.05);但各不同泵设流量下,P组再循环率显著高于T组(均P＜0.01).结论 两种永久性双腔血液透析留置导管血流量能满足泵设流量需求,正接时都没有再循环;反按时Tal Palindrome TM型再循环率比Permcath型低,两种导管再循环率不随泵设流量的增加而增加.因此,应尽量避免反接导管,必须反接时,可相应提高血流量,以保证透析效果.     

超声在血液透析动静脉内瘘术后并发症预防中的应用价值

目的探究多普勒超声在血液透析动静脉内瘘术后并发症预防中的应用价值,为终末期肾病患者血液透析动静脉内瘘术后并发症的预防提供临床指导。方法选择2016年1月到2018年12月在本院进行治疗的终末期肾病患者68例为研究对象。依据血流量上、下四分位数后取整,分为高流量组(大于1500ml/min)15例,中流量组(介于800～1000ml/min)36例,低流量组(小于800ml/min)17例。选择多普勒超声对患者进行动静脉内瘘同管腔内外、吻合口内和血流情况等观察,对血液透析动静脉内瘘术后患者的并发症发生状况进行评估。结果68例终末期肾病患者中,31例(45.59%)有通畅的动静脉内瘘,能够满足血液透析要求的正常血流量;37例(54.41%)发生并发症,其中血栓形成有16例,假性动脉瘤有3例,内瘘血管旁软组织内血肿3例,静脉瘤样扩张8例,管腔狭窄有5例,内瘘发育不成熟2例;高流量组与低流量组并发症发生率为53.33%与76.47%,均明显高于中流量组25.00%,低流量组和高流量组的并发症发生率相比,差异无统计学意义(χ~2=2.015,P=0.182)。结论采用多普勒超声对血液透析动静脉内瘘术后患者进行检查,能及时发现并发症,尽早进行治疗,进而对内瘘的使用时间进行延长,值得推广应用。     

血泵流量和动静脉瘘血流量对维持性血液透析患者血压和心功能的影响

目的研究血泵流量(blood pump flow rate,Qb)和动静脉瘘血流量(arteriovenous blood flow rate,Qa)对维持性血液透析患者血压和心功能的影响。方法分析2017年1月至2019年1月于无锡市锡山人民医院行血液透析治疗的120例患者,根据流量中位数将患者分为低流量组(Qb220 mL/min,Qa1 000 mL/min)和高流量组(Qb≥220 mL/min,Qa≥1 000 mL/min),透析前30 min和后30 min应用超声稀释法测量患者的心脏功能参数。多元线性回归模型用于分析变量与血压及心脏功能参数的相关性。结果透析过程前30 min与后30 min应用超声稀释法测量患者的心脏功能参数,结果发现后30 min的Qa、心输出量(cardiac output,CO)、心脏指数(cardiac index,CI)和中心血容量(central blood volume,CBV)明显低于前30 min(P0.05),后30 min的外周血管阻力(peripheral vascular resistance,PVR)明显高于前30 min(P=0.018)。而心率(heart rate,HR)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、平均动脉压(mean arterial pressure, MAP)和Qb没有显著统计学差异(P0.05)。透析的前30 min,Qb高流量组相对Qb低流量组的DBP和MAP更高(P0.05;在透析的后30 min,与Qb低流量组相比,Qb高流量组的SBP,DBP和MAP更高(P0.05),Qa高流量组的SBP、MAP、CO、CI、CBV相对Qa低流量组更高,而PVR却更低(P0.05)。多元线性回归模型的结果显示在透析后30 min,Qb与SBP和MAP呈明显相关(P0.05);Qa与CO、CI、HR和PVR呈明显相关(P0.05)。结论 Qb≥220 mL/min,Qa≥1 000 mL/min会对患者的血压和心功能指标产生一定的影响。     

维持性血液透析患者并发急性胰腺炎3例报告

慢性肾衰竭（CRF）患者易并发胰腺炎（AP）的研究报道较多。但终末期肾衰竭行维持性血液透析患者并发急性胰腺炎（AP）的报道较少。据统计,CRF长期透析患者AP发病率约为2．3％,其中血液透析（HD）患者并发AP的发病率较之更低,为0．63％～1．41％。回顾性分析2008年1月～2010年1月我院血透中心所有患者临床资料,     

Comparison of predilution hemodiafiltration and low-flux hemodialysis at temperature-controlled conditions using high calcium-ion concentration in the replacement and dialysis fluid

BACKGROUND: It is the prevailing view that convective dialysis techniques stabilize blood pressure. The aim of this study was to compare the hemodynamics of high-dose predilution hemodiafiltration (HDF) and low-flux hemodialysis (HD), under matched conditions and using high calcium-ion concentration in the replacement/dialysis fluid. METHODS: 13 stable hemodialysis patients were investigated in a randomized crossover, blinded controlled trial. The patients were allocated to one session of predilution HDF (substitution fluid 1.20 1/kg BW) and one session of HD at 4.5 hours. At the start of the dialysis the patient's core temperature was "locked" by an automatic feedback system regulating the dialysate temperature, thereby patient's temperature was kept stable throughout the whole treatment. The Ca ion concentration in the substitution/dialysis fluid was 1.75 mM. Cardiac output was measured hourly by the ultrasound velocity dilution method. RESULTS: Within treatments comparisons revealed that both treatments displayed stable mean blood pressure and equally reduced cardiac output. HDF showed decreased stroke volume and increased total peripheral resistance. The pulse rate decreased significantly only during HD. Arterial temperature was kept constant during both treatments. Ultrafiltration volume, cardiopulmonary recirculation, relative blood volume, Kt/V and total energy transfer were matched for HD and HDF. The overall between treatments comparisons revealed no significant differences. CONCLUSIONS: We have shown that during matched conditions and high calcium concentrations, the hemodynamic profiles of high dose predilution HDF and lowflux HD were similar. Both modalities showed stable mean blood pressure profiles. An acute circulatory benefit of convective solute removal over diffusive, could not be demonstrated.     

维持性血液透析患者内瘘血流量与炎性反应状态的关系及对心血管病的影响

目的 探讨维持性血液透析(MHD)患者内瘘血流量与炎性反应状态的关系及其对心血管病(CVD)的影响.方法 30例以自体动静脉内瘘(AVF)为透析通路的MHD患者(MHD组)及12例健康体检者(对照组)入选本研究.Transonic HD 02透析监测仪监测内瘘血流量(Qa)和心输出量(C0).MHD组在监测Qa前取透前血标本,对照组标本来自我院健康体检人群.用免疫透射比浊法检测高敏C反应蛋白(hsCRP);用流式细胞仪的液相蛋白定量技术检测炎性因子白细胞介素(IL)2、IL-6、IL-10、肿瘤坏死因子(TNF).随访时间19个月,记录发病情况.结果 两组年龄及性别差异无统计学意义.MHD组透前IL-6、IL-10、TNF、hsCRP均显著高于对照组[2.38( 1.86 ～4.69)比1.14(0.27～1.18) ng/L,P＜0.01;1.47(1.19～2.10)比1.04 (0.00～1.23) ng/L,P＜0.01;1.33(1.05～1.56)比0.54(0.00～1.24) ng/L,P＜0.05;4.90( 1.58～7.45)比1.50( 0.63～1.90) mg/L,P=0.01].随访期间,6例(20.0％)患者至少发生1次心血管病.发生心血管病者Qa、IL-6、hsCRP均显著高于未发病者[(1120±192)比(893±189) ml/min,P＜0.05;4.86 (2.96～7.85)比2.20 (1.80～3.10) ng/L,P＜0.01;11.75(3.83～31.53)比4.45(1.05～6.68) mg/L,P＜0.05].二元Logistic回归分析显示,IL-6为CVD的独立危险因素(HR=1.943,95％CI:1.110～3.402,P=0.02).Spearman相关分析及线性回归分析显示,Qa与IL-6呈正相关(β=0.492,P＜0.01).路径分析结果显示,Qa通过IL-6对CVD有间接的显著影响.结论 IL-6是CVD发生的独立危险因素.Qa与IL-6呈正相关.Qa可通过影响MHD患者IL-6水平参与了CVD的发生.     

The Role of Arterio-Venous Shunt in the Pathogenesis of Pulmonary Hypertention in Patients with End-stage Renal Disease

Pulmonary hypertension (PHT) is an overlooked cardiovascular morbidity in patients with end stage renal disease. The pathogenesis of PHT in this group of patients is not explained satisfactorily. The aim of our study to evaluate the prevalence and the role of AV shunt in pathogenesis of pulmonary hypertention. Our study included 58 patients with ESRD without a known cause of PHT who were either in the predialysis period (stage 1V CKD) (14 patients) or maintained on chronic hemodialysis (stage V CKD) (44 patients) in Theodor Bilharz Research Institute (TBRI), Cairo, Egypt. In the chronic hemodialysis group, there were 27 males and 17 females with a mean age of 57.11 ± 12.31 years (range 28–65). In the predialysis group, there were 8 males and 6 females with a mean age 53.45 ± 9.41 years (range 28–66). Pulmonary arterial pressure (PAP) and cardiac output were evaluated by Doppler echocardiography in the 14 pre-dialysis patients without PHT few (4.3 ± 0.8) months after creation of AV fistula and in the 44 hemodialysis patients (33.6 ± 4.2 months) after creation of AV fistula within 1 h of completion of hemodialysis session. Arteriovenous fistula (AVF) flow was measured by Doppler sonography. PHT (systolic PAP ≥35 mm Hg) was observed in 25 (56.8%) patients receiving hemodialysis with a mean systolic PAP of 46.4 ± 13.6 mm Hg. In the predialysis group after creation of AV fistula, PHT was found in 6 (42.9%) patients with a mean systolic PAP of 42.8 ± 12.8 mm Hg. The cardiac output and AV shunt flow were found to be increased in patients with elevated systolic PAP in both groups (p < 0.05). CRF duration and AV fistula duration were positively correlated with systolic PAP in patients receiving hemodialysis (p < 0.05). After compression of AV fistula in 11 hemodialysis patients, the mean value of PHT decreased (from 43.98 ± 15.6 to 33.22 ± 11.7 mm Hg). This study demonstrates a high prevalence of PHT among patients with ESRD in predialysis period after creation of AV fistula and on chronic HD via a surgical A-V fistula. Cardiac output, AV shunt flow and duration, and ESRD duration may be involved in the pathogenesis of PHT. The development of PHT following access formation represents a failure of the pulmonary circulation to accommodate the access-mediated elevated CO. Pre-dialysis patients scheduled for access formation should be screened for the presence of sub-clinical PHT.     

A novel simple hemoglobin dilution technique to measure hemodialysis vascular access flow

Measurement of the vascular access flow rate (Q(a)) is a widely accepted method for surveillance and predicting access failure. Among current practical methods, the ultrasound dilution technique is standard, but this requires a costly device available in few hemodialysis (HD) centers. Here, we devised a simple hemoglobin dilution technique to accurately measure Q(a) without the need for any special machines. Before HD, values of Q(a) were determined in each of 30 patients by hemoglobin dilution and then, in the same session, by ultrasound dilution. There was a significant correlation between the two techniques using automated hemoglobin and hematocrit or centrifuge-measured hematocrit levels to calculate HD fluid-derived Q(a) values. Our study shows that the HD dilution technique, using no special device, is economical, highly accurate, and easy to perform, and can be used as an alternative to standard ultrasound dilution for vascular access surveillance.     

不同心功能状态下血液透析患者血液动力学变化及其影响因素

目的 研究维持性血液透析患者血液透析过程中血液动力学变化,探讨不同心功能状态下的血液动力学改变及其影响因素.方法 收集本院规律性血液透析患者临床资料,采用超声稀释法检测患者动静脉内瘘流量(Qa)和透析后1h、2h和3h的血液动力学指标,包括心输出量(CO)、心搏出量(SV)、心脏指数(CI)、中心血容量(CBV)、中心血容量指数( CBVI)、外周血管阻力(PR)等参数.结果 75例患者平均年龄为(55.84±12.39)(21 ～81)岁,女性占57.3％.随着透析的进行,患者收缩压、SV、CO、CI及CBV显著下降,PR增加,而舒张压及心率的变化差异无统计学意义.根据透析后1 hCI值,将患者分为＜2.5 L·min-1·(m2)-1组、2.5～4.2 L·min-1· (m2)-1组和＞4.2 L·min-1·(m2)-1 3组.前两组患者透析3h后SV、CO、CBV较透析1h明显下降,PR增高(P均＜0.01),CI＜2.5 L·min-1· (m2)-1组最为明显,而CI＞4.2 L·min-1·( m2)-1组前后血液动力学指标无明显差异.CI与Qa、收缩压、平均动脉压、年龄、糖尿病、PR相关.结论 血液透析过程血液动力学改变表现主要为血压、CO、CI以及CBV降低,PR增高.不同CI患者透析过程中血液动力学改变程度不同,CI＜2.5 L·min-1· (m2)-1组患者血液动力学改变最为明显.CI与Qa、收缩压、年龄、糖尿病有相关关系.     

The electrical impedance indicator dilution method in studying the basic hemodynamic parameters during dialysis

The procedure for measuring cardiac output and circulating blood volume is based on blood ability to modify its electrical conductance due to the amount of introduced ions (0.9% sodium chloride solution) or undissociated molecules (5% glucose solution). The cardiac output and circulating blood volume were calculated after measuring an area under the electrical impedance indicator dilution curve using the given formulas. With the described and thermodilution methods, the cardiac output was compared (r = 0.95). The correlation factor with the radioisotopic method in measuring the circulating blood volume was 0.88. Clinical investigations carried out in 47 patients on a programmed hemodialysis showed a significant decrease in cardiac output approximately by 700 ml/mi (7.9%) and circulating blood volume by an average of 900 ml (15.2%) by the end of a hemodialysis session, the rate of the circulating blood volume to body weight being also decreased. There was a predominant fluid "release" from the vascular bed.     

Doppler examination of cerebral arteries in uremic children

Transcranial Doppler ultrasonography is a useful method for the estimation and monitoring of cerebral circulation in dialyzed patients. The aim of this study was to evaluate the effect of disease and treatment on cerebral circulation in children on maintenance hemodialysis (HD) and children prior to renal replacement therapy. We demonstrated that in uremic children blood flow velocities of the internal carotid artery (ICA), anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) 120 min and 240 min from the beginning of an HD session were significantly lower than values immediately before HD. Changes in blood flow velocities of MCA and ACA during HD correlated significantly with changes in mean arterial pressure during HD. There was no correlation between changes in blood flow velocities and intradialytic changes in hematocrit values, ultrafiltration, hemoglobin concentration, and blood urea nitrogen values. Mean blood flow velocities of ICA, MCA, and PCA in euvolemic children on conservative treatment were significantly higher than after a HD session in children on maintenance HD. The factors responsible for intradialytic velocity changes of cerebral arteries in uremic children require further examination. Received August 21, 1997; received in revised form June 12, 1998; accepted June 15, 1998     

The relationship between arteriovenous fistula blood flow rate and pulmonary artery pressure in hemodialysis patients

Purpose Although there is an increased prevalence of pulmonary hypertension in hemodialysis patients, the relationship between arteriovenous (AV) fistula blood flow and pulmonary hemodynamics is not known. The aim of this study was to evaluate the relationshipship between blood flow rate of AV fistula and pulmonary artery pressure (PAP) in hemodialysis patients. Methods Thirty-two hemodialysis patients were included in this study. Within 1 h of completion of dialysis, blood flow rate of AV fistula and pulmonary hemodynamics were evaluated using Doppler sonography. Pulmonary hypertension was defined as mean PAP ≥25 mmHg at rest. Results Mean PAP, median blood flow rate of AV fistula, and mean cardiac index were 22.5 ± 10.0 mmHg (range 8–39), 978.0 ml/min (interquartile range 762.0–1,584.5) and 3,043.0 ± 694.3 ml/min per m² (range 1,251–4,140), respectively. Mean PAP has a relationship to cardiac index (r = 0.453, P = 0.014). However, there was no correlation between mean PAP and blood flow rate of AV fistula, hemoglobin, calcium-phosphorus (CaxP) product, and parathormone. Pulmonary hypertension was present in 43.7% of patients. Patients with pulmonary hypertension had significantly higher cardiac index (P = 0.036). Conclusions We found there was no direct relationship between blood flow rate of AV fistula and PAP. Other factors may play a role in the development of pulmonary hypertension.