The primary arteriovenous fistula failure—a comparison between diabetic and non-diabetic patients: glycemic control matters

Abstract

Presence of diabetes mellitus has been shown to be related with the occurrence of primary arteriovenous fistula (AVF) failure in some but not in all studies. In the current study, we examined whether glycemic control as evaluated by HbA1c is independently related with primary AVF failure. We recorded sociodemographic, clinical, and laboratory parameters of the patients from medical records and hospital charts prior to AVF surgery. Primary AVF failure was described as a complication of the AVF before the first successful cannulation for HD treatment. Our study comprised of 160 non-diabetic (Group1) and 73 diabetic patients. Among diabetic patients, 37 had HbA1c values <7% (Group 2) and 36 patients had HbA1c values ≥7% (Group 3). In total, 74 (31.8%) patients had a history of primary AVF failure. The percentages of primary AVF failure were 27.5, 29.7, and 52.8% in Group 1, Group 2, and Group 3, respectively (P: 0.013). The percentage of patients with primary AVF failure was significantly lower in Group 1 and Group 2 than in Group 3 (P:0.003 and P:0.045, respectively). There was no difference with respect to primary AVF failure between Group 1 and Group 2 patients. We suggest that poor glycemic control as assessed by HbA1c may be an important factor for the development of primary AVF failure among diabetic subjects. It is possible that differences with respect to AVF failure between diabetic and non-diabetic patients may be partly attributed to glycemic control.