Objective To compare the effects of 2 vascular accesses via arteriovenous fistula(AVF)and tunnel-cuffed catheter(TCC)in elderly patients with maintenance hemodialysis(MHD).Methods A total of 103 elderly MHD patients were selected and divided into the AVF group(43 cases)and the TCC group(60 cases)according to different vascular pathways.Laboratory indexes of serum creatinine,uric acid,parathyroid hormone(PTH),serum calcium,blood phosphorus,hemoglobin,triglyceride and total cholesterol were compared between the two groups on dialysis day after receiving regular hemodialysis treatment for 1 year.Blood flow and urea clearance in vascular pathway were also compared between the two groups.The left ventricular end-diastolic diameter(LVEDd),the left ventricular posterior end-diastolic thickness(LVPWT),the ventricular septal end-diastolic thickness(IVSTd),ejection fraction(EF),the maximum flow velocity ratio(E/A)of the left atrial ventricle at the early and late diastolic stages and pulmonary artery pressure were examined by echocardiography after regular hemodialysis treatment for 1 year.The occurrence rates of left ventricular systolic dysfunction and diastolic dysfunction were recorded.Hemodialysis access associated infection,mechanical injury and heart failure during dialysis were also recorded.Results There were no significant differences in laboratory indexes between the two groups(P＞0.05).LVEDd,IVSTd,LVPWT,incidence rates of left ventricular systolic dysfunction,diastolic dysfunction,blood flow through vascular channels,Kt/V and mechanical injury were higher in the AVF group than those in the TCC group,while the ratio of hemodialysis access associated infection,E/A and EF values were lower in the AVF group than those in the TCC group(P＜0.05).There were no significant differences in incidence rates of pulmonary arterial pressure and heart failure between the two groups(P＞0.05).Conclusion For elderly MHD patients,the appropriate dialysis access should be determined after evaluating underlying diseases and vascular conditions.