Diabetes should not dissuade arteriovenous fistula formation

Gordon, Andrew C.; Dholakia, Shamik; Ashby, Damien; Crane, Jeremy

doi:10.15277/bjd.2016.077

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…On the contrary, many authors have stated that diabetes is associated with a higher risk of AVF failure. In this regard, Jeong et al reported higher mortality rates and worse AVF patency rates in diabetic patients vs. non-diabetic ESRD patients undergoing hemodialysis (11). In a previously reported systematic review, there is an increased risk of AVF failure in ESRD patients with diabetes (12).…”

Section: Discussionmentioning

confidence: 99%

Early Failure of Arteriovenous Fistula (AVF): The Effect of Diabetes and Hypertension in a Cross-Sectional Study

Bahrami-Ahmadi

Zadeh

Chehrehgosha

et al. 2022

Med. J. Islam. Republ. Iran

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Background: Identification and control of clinical predictors of arteriovenous (AVF) failure can improve the long-term outcome of hemodialysis patients. The effects of these factors on the outcome of AVF are not still clear. So, we aimed this study to compare the effect of hypertension and diabetes on early failure of AVF.Methods: In this retrospective study, we evaluated 400 patients with ESRD referred to our clinic for the creation of the first AVF from July 14, 2001, through August 7, 2018. One month after AVF creation, the patients were referred to the clinic for patency control. Demographic characteristics, previous history of diabetes and hypertension, and laboratory data of all patients were recorded preoperatively. Data were entered to SPSS v.24 and Study data were analyzed with chi-square and independent student t-test. Then, early failure of AVF and its relationship with a history of diabetes and hypertension were assessed.Results: There was no statistically significant relationship between the history of diabetes and early AVF failure risk in ESRD patients (OR, 0.78; 95% CI, 0.25 to 2.43). Furthermore, the history of hypertension was significantly lower in the early failure of AVF group (OR, -2.82; 95% CI, -1.42 to -5.59). Although, this effect faded when using regression analysis (OR, -2.67; 95% CI, -0.97 to -7.36). There was a higher Body mass index in the non-early failure group (p = 0.041). There was no significant difference in age (p = 0.512), gender (p = 0.091), history of smoking (p = 0.605), treatment with insulin (p = 0.683), oral antidiabetic agents (p = 0.734), duration of diabetes (p = 0.384), and duration of hypertension (p = 0.093). Conclusion:We reported that the history of diabetes was not higher in the early failure group, while there was a lower risk of AVF failure in patients with a previous history of hypertension.

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Section: Discussionmentioning

confidence: 99%

Early Failure of Arteriovenous Fistula (AVF): The Effect of Diabetes and Hypertension in a Cross-Sectional Study

Bahrami-Ahmadi

Zadeh

Chehrehgosha

et al. 2022

Med. J. Islam. Republ. Iran

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“…Study by Ahmadi involving 400 patients reported that diabetes did not increase the risk of early AVF failure, while patients with a previous history of hypertension had a lower risk of AVF failure [20]. Gordon concluded that diabetic patients should not be discouraged from undergoing AVF formation, as they have comparable outcomes to non-diabetic patients, with AVF remaining the optimal access for dialysis [21].…”

Section: Discussionmentioning

confidence: 99%

Relevance of Preoperative Vessel Mapping and Early Postoperative Ultrasonography in Predicting AV Fistula Failure in Chronic Kidney Disease Patients

Gupta,

Ahmed,

et al. 2024

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Introduction: The increasing prevalence of chronic kidney disease (CKD), coupled with advancements in the diagnosis and treatment of renal diseases and improvements in life expectancy, has led to a greater number of patients requiring hemodialysis. The preferred method of vascular access for hemodialysis is AV fistula formation; however, it is associated with a high rate of failure. In our prospective study, we focused on 40 CKD patients planned for initiation of maintenance hemodialysis. Methods: We employed preoperative ultrasound mapping to assess cephalic vein diameter, compressibility, and colour flow, as well as radial and brachial artery diameter, peak systolic velocity, and intimal wall calcification. Postoperatively, ultrasound examinations were conducted on day 7 and at 6 weeks to evaluate fistula blood volume and detect any complications. Results: A significant association between fistula failure and cephalic vein diameter, brachial artery diameter, intimal vessel wall calcification, and comorbid conditions like diabetes mellitus was observed. Furthermore, blood flow at day 7 was notably lower in the failure group compared to those with a functioning fistula and any fistula with blood flow <154 ml/min on day 7 may be predictive of early fistula failure. Conclusion: Preoperative vessel mapping and early postoperative ultrasonography is indispensable for patients who require AV fistula formation for hemodialysis and provide valuable information for selecting suitable vessels for successful fistula creation and enable early intervention to salvage a failing fistula after the surgery. By utilizing these, healthcare professionals can make informed decisions and take necessary steps to optimize the outcomes of AV fistula formation in patients undergoing hemodialysis.

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Brief overview of surgical aspect of autologous arterio-venous fistula for dialysis access

Kashyap

Danish

Magatapalli

et al. 2021

Asian Cardiovasc Thorac Ann

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Patients with the end-stage renal disease require renal replacement therapy in renal transplant, peritoneal dialysis, and intermittent hemodialysis. Hemodialysis remains the primary modality for renal replacement therapy. Excellent vascular access is a mainstay for performing hemodialysis. Here we present a brief review of the various surgical aspects of AV fistula creation. Preoperative physical examination and judicious use of the imaging modalities to define the artery and venous mapping provide a good outcome of the fistula formation. Surgical creation of RC-AVF is preferred for the end-stage renal disease patient. The end-to-side anastomosis between the radial artery and cephalic vein has shown very good results.

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Diabetes should not dissuade arteriovenous fistula formation

Cited by 5 publications

References 18 publications

Early Failure of Arteriovenous Fistula (AVF): The Effect of Diabetes and Hypertension in a Cross-Sectional Study

Early Failure of Arteriovenous Fistula (AVF): The Effect of Diabetes and Hypertension in a Cross-Sectional Study

Relevance of Preoperative Vessel Mapping and Early Postoperative Ultrasonography in Predicting AV Fistula Failure in Chronic Kidney Disease Patients

Brief overview of surgical aspect of autologous arterio-venous fistula for dialysis access

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