Comparison Primary Failure and Primary Patency Rates of Distal Radiocephalic Arteriovenous Fistulas in Diabetic and Non Diabetic Patients

Abstract

A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The radiocephalic arteriovenous fistula (avf) at the wrist is the first choice for hemodialysis access. Several authors have reported diabetes mellitus (DM) as an independent risk factor on primary failure and patency of the fistula, also reports stating that DM is only a clinically comorbid factor. We aimed to investigate the effect of DM on primary failure and patency rates of distal radiocephalic avf. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 87 patients (43 diabetic and 44 non diabetic) who underwent distal radiocephalic avf operations between May 2011-January 2013 were reviewed retrospectively. Demographic findings and data about radial artery and cephalic vein were documented. Primary failure and 6 months primary patency of the fistula were also calculated retrospectively. R Re es su ul lt ts s: : The mean cephalic vein diameters were similar but the mean radial artery diameter (2.34±0.26 mm versus 2.63±0.38 mm, p=0.0002) and the mean radial artery flow (25.05±11.8 ml/min versus 28.9±11.3 ml/min. p=0.0277) of the diabetic group were significantly lower. There were no significant differences on primary failure and primary patency rate for 6 months. C Co on nc cl lu us si io on n: : Even though the mean radial artery diameter and flow were lower in diabetic group, there are no significant differences at primary failure and patency rates. By so we conclude that DM is not an independent risk factor on primary failure or patency rate of the fistula but may be a comorbid factor. Radiocephalic arteriovenous fistula at the wrist remains our first choice for both diabetic and non-diabetic patients.K Ke ey y W Wo or rd ds s: : Diabetes complications; arteriovenous fistula; kidney failure, chronic Ö ÖZ ZE ET T A Am ma aç ç: : Kronik böbrek yetmezlikli hastalarda hemodiyaliz tedavisinin el bileği seviyesinde oluşturulan radiosefalik arteriovenöz fistül (avf) ile yapılması ilk tercih edilen yöntemdir. Bazı otör-ler Diabetes Mellitus (DM) hastalığını, fistülün açıklık süresinde ve olgunlaşma başarısızlığı konusunda net olarak olumsuz bir risk faktörü olarak tanımlasa da bazıları bu durumu sadece klinik bir komorbidite olarak tanımlamaktadır. Biz de bu çalışmamızda bu çelişkili durumu aydınlatmayı planladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Hastanemizde Mayıs 2011-Ocak 2013 tarihleri arasında el bileği seviyesinden avf ameliyatı olan 87 hastanın (43 diyabetik ve 44 diyabetik olmayan) demografik verileri ile radial arter ve cephalic ven ile ilgili verileri geriye doğru tarandı. Fistül olgunlaşmasında başarısızlık durumu ile 6 aylık açıklık süreleri incelendi. B Bu ul lg gu ul la ar r: : Ortalama sefalik ven çapları arasında fark yok iken, ortalama radial arter çapı (2,34±0,26 mm ve 2,63±0,38 mm, p=0,0002) ve ortalama radial arter akımı (25,05±11,8 ml/dak ve 28,9±11,3 ml/dak, p=0,0277) diyabetik grupta diyabetik olmayan gruba göre anlamlı oranda düşük tespit edildi. Fistül olgunlaşmasında başarısızlık ve 6 aylık açıklık oranları...

Comparison of primary patency of radiocephalic and brachiocephalic arteriovenous fistula in East Borneo, Indonesia

“…We found diabetes not significantly affect patency in either AVF, this finding is comparable to a study by Kocaaslan et al conducted on 87 people (43 diabetic and 44 non-diabetic patients) and it is said that the factor of arterial diameter and reduction of artery flow reduces primary patency. 19 According to Diehm et al on the access outcome of diabetic female patients, they noticed that being female and diabetic are risk factors affecting the patency outcome. 20 In comparison, non-diabetic patients showed prolonged primary patency due to reduced arterial calcifications, greater vessel diameter as well as increased arterial peak systolic volume.…”