Differences in the success rate of the surgical creation of vascular access for hemodialysis in patients with and without diabetes

Abstract

The most preferred vascular access method for hemodialysis in patients with end-stage renal disease is the autologous arteriovenous fistula (AVF). However, a significant percentage of AVF fails to support dialysis therapy due to a lack of adequate maturity. Among all the factors, the presence of diabetes has been identified by some authors to be one of the risk factors for vascular access failure; however, some other authors found no such association. Therefore, this study aimed to evaluate the correlation between diabetes and the success rate of AVF. Among the 125 patients included in the study, 75 were female (60%), a total of 151 autologous arteriovenous fistulas were performed. Among the patients, 22 underwent surgery twice at two different sites (17.6%), and 2 patients underwent surgery three times at three different sites (1.6%). Early fistula occlusion and failure to mature occurred in 34 out of 151 cases (22.5%). Among these, 54 of 67 patients with diabetes (80.6%) and 63 of 84 patients without diabetes (75%) had successful fistula maturation and were able to undergo hemodialysis. The difference was not statistically significant. Diabetic vasculopathy, particularly in patients with end-stage chronic kidney disease, presents a number of specific problems, the most important of which appears to be arterial calcification and stiffening.