The relationship between vascular access and clinical, nutritional and laboratory parameters in patients undergoing hemodialysis treatment

End-stage renal disease (ESRD) is a progressive disorder characterized by a persistent decline in glomerular filtration rate (GFR), leading to the accumulation of uremic toxins and disruption of fluid-electrolyte balance in the body. Patients with ESRD require renal replacement therapy to sustain life, and one of the most widely used modalities for this purpose is hemodialysis (HD). For effective HD treatment, appropriate vascular access to the patient's bloodstream must be established; the most commonly used vascular access routes for HD are arteriovenous fistula (AVF) and central venous catheter (CVC). The choice of vascular access has a significant impact on the efficacy of HD treatment and clinical outcomes such as the risk of complications, morbidity, and mortality. The aim of this study was to investigate the effects of AVF and CVC, two different vascular access routes used in patients undergoing HD, on inflammation, malnutrition, and several biochemical parameters. A total of 100 patients undergoing HD (50 with AVF and 50 with CVC) were included in the study. Demographic data, clinical features, nutritional parameters [e.g., serum albumin, body mass index (BMI), Prognostic Nutritional Index (PNI)], inflammatory markers [C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), ferritin], laboratory values (e.g., calcium, phosphorus, parathyroid hormone [PTH], hemoglobin), and dialysis adequacy parameters (Kt/V, URR) of all patients were recorded. Additionally, the suprailiac subcutaneous fat thickness of the patients was measured using a skinfold caliper. The AVF and CVC groups were compared in terms of these parameters, and the relationship between dialysis duration and nutritional and inflammatory indicators was also assessed. Statistical analyses were performed using the Mann-Whitney U and Chi-square tests, as well as Spearman correlation; p<0.05 was considered statistically significant. Although patients in the AVF group had a longer dialysis duration compared to those in the CVC group, their nutritional status and dialysis adequacy were found to be better. Serum albumin and PNI values were significantly higher in the AVF group compared to the CVC group, while CRP and NLR levels, although higher in the CVC group, did not reach statistical significance. Dialysis adequacy parameters (Kt/V and URR) were also significantly higher in the AVF group (p<0.05), although the CVC group also met the recommended targets. Additionally, patients using CVC were found to have greater weight loss over the past six months and a higher frequency of hospitalizations within the last year compared to those in the AVF group. The findings obtained are consistent with the existing literature and demonstrate that the use of AVF in HD patients is more advantageous than CVC in terms of inflammation and nutritional status. The observation of lower inflammation and better nutritional profiles in AVF patients emphasizes the importance of prioritizing AVF as the vascular access of choice.