Effect of needles distance of arteriovenous fistula cannulation on hemodialysis adequacy based on KT/V: a randomized controlled trial

Background: This study aims to assess the effect of needle distance of arteriovenous fistula (AVF) cannulation on hemodialysis adequacy based on KT/V. Materials and Methods: This study was a parallel-group, randomized controlled trial. Patients who met the inclusion criteria were divided into two groups with 3 and 6 cm needle distances using block randomization. Data acquisition transpired through a comprehensive checklist encompassing demographic variables such as age and gender, alongside clinical metrics comprising actual weight, dry weight, average dialysis duration, fistula longevity, and KT/V rate. Results: A total of 42 hemodialysis patients were enrolled in this investigation, with 21 allocated to the 3 cm needle distance group and another 21 to the 6 cm needle distance group. The mean post-hemodialysis KT/V values for the 3 cm and 6 cm needle distance groups were 1.25 (SD=0.25) and 1.42 (SD=0.24), respectively, demonstrating a statistically significant difference (P<0.001). While there was no significant difference in the average pre- and post-hemodialysis KT/V values within the 3 cm needle distance group (t=1.93, P=0.068), the corresponding values for the 6 cm needle distance group exhibited a notable discrepancy (t=9.66, P<0.001). Conclusion: In general, a needle distance of 6 cm between arteriovenous points yielded superior enhancements in dialysis adequacy compared to a 3 cm needle distance following hemodialysis. Consequently, health administrators and policymakers may consider instituting efficacious interventions to scrutinize the care and therapeutic protocols for hemodialysis patients, involving the development of policies and applications.