Relationship Between Quick of Blood with Arteriovenous Radiocephalic And Brachiocephalic Fistula to Blood Urea Nitrogen (BUN), Creatinine Serum, Neutrophil to Lymphocyte Ratio (NLR), And Hemoglobin in Patients Hemodialysis

Abstract

Chronic kidney disease (CKD) is a chronic disease with a high prevalence worldwide. In 2017, an estimated 1.2 million people died from CKD globally. There are 713,783 CKD sufferers (0.38%) in Indonesia aged 15 years who have been registered nationally. Hemodialysis (HD) is one of three renal replacement therapies for managing CKD. Adequate vascular access is required in patients undergoing HD. Vascular access is ideal if it causes minor complications when used for hemodialysis. Arteriovenous fistula (AVF) is a common vascular access used during HD. The main options for AVF are radiocephalic (RC) and brachiocephalic (BC) fistula, with their respective advantages and disadvantages. This cross-sectional study compares QB in patients with RC and BC fistula and with hematological parameters pre and post-HD. There were 18 RC subjects and 18 BC subjects involved in this study. Subjects were then examined for hematological parameters and QB before and after HD. The results of this study showed that QB in the RC group was not significantly different from the BC group (p=0.126). The mean comparative test showed that the levels of Hb, BUN, and SC were significantly different before and after HD both in the RC group (p=0.005; p=<0.001; p=<0.001) and BC (p=0.001; p =<0.001; p=<0.001). The correlation test results showed that QB only correlated with SC pre-HD levels (p=0.030; r=0.361). Multivariate tests showed that the decrease in BUN levels with AV fistula BC was higher than with RC (p=0.015). This study proves that QB is unrelated to the type of AV fistula used, but QB is positively correlated with serum creatinine levels in patients undergoing HD. BC fistula were also found to lower BUN levels better than RC fistula.