Abstract： Objective:To investigate the impacts of pump-controlled blood flow on cardiac load and vascular access stenosis in patients on maintenance hemodialysis (MHD) .Methods:A total of 92 patients undergoing MHD in our hospital between April 2019 and April 2020 were recruited. According to the pump-controlled blood flow during hemodialysis, they were divided into the low blood flow group (<220 ml/min, n=44) and the high blood flow group (≥220 ml/min, n=48) , both on continuous hemodialysis for 6 months. At 3 and 6 months of treatment, the two groups were recorded for vascular access stenosis. Before and at 6 months of treatment, cardiac load was measured for the two groups, including myocardial performance (Tei index) , left ventricular ejection fraction (LVEF) and stroke volume (SV) . Before and at 6 months of treatment, serum levels of C-reactive protein (CRP) , creatinine (Cr) and hemoglobin (Hb) were examined for the two groups. Complications such as internal fistula dysfunction and high-risk events during hemodialysis were recorded. Results:There was no significant difference in the rate of vascular access stenosis between the two groups at 3 months of treatment ( P>0.05) . At 6 months of treatment, the rate of vascular access stenosis was significantly higher in the low blood flow group than that in the high blood flow group (27.27% vs 10.42%, P<0.05) . Before treatment, there were no significant differences in Tei index, LVEF and SV between the two groups (all P>0.05) . At 6 months of treatment, the Tei index, LVEF and SV in either group were significantly increased compared with baseline, and these values were significantly higher in the high blood flow group than those in the low blood flow group (all P<0.05) . Before and at 6 months of treatment, there were no significant differences in serum levels of CRP, Cr and Hb between the two groups (all P>0.05) . At 6 months of treatment, the serum CRP and Cr levels were significantly lower, and the Hb level was significantly higher, compared with baseline, in either group (all P<0.05) . The incidence of internal fistula dysfunction was 25.00% (11/44) in the low blood flow group vs 8.33% (4/48) in the high blood flow group, suggesting that the low blood flow group had significantly higher incidence of internal fistula dysfunction compared with the high blood flow group ( χ2=4.67, P=0.031) . The incidence of high-risk events in the low blood flow group was 13.64%, which was significantly lower than 31.25% as in the high blood flow group ( χ2=4.04, P=0.044) . Conclusion:The level of blood flow should be properly selected according to clinical practice during MHD, so as to reduce complications and improve the therapeutic efficacy of hemodialysis.