Predictive Parameters of Arteriovenous Fistula Maturation for Hemodialysis in
Patients with Diabetes Mellitus

 

Radojica Stolić¹, Marija Milić², Vekoslav Mitrović³, Bratislav Lazić²,
Suzana Milutinović⁴, Snezana Lazić², Kristina Bulatović², Vladimir Mitrović²,
Andrijana Karanović², Sanja Jovanović²

 

¹1University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
²University of Pristina temporarily seated in Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
³University of East Sarajevo, Faculty of Medicine Foča, Department of Neurology, Foča, Republic of Srpska,
Bosnia and Herzegovina
⁴Academy of Educational and Medical Vocational Studies, Department of Ćuprija seated in Kruševac, Serbia

 

 SUMMARY

 

Introduction/Aim. Arteriovenous fistula (AVF) is recommended as the ideal vascular access for hemodialysis (HD), however, there are conflicting opinions when it comes to patients with diabetes mellitus (DM). The aim of the paper was to determine the predictive parameters of AVF maturation for HD in patients with DM.
Methods. The investigation was organized as a retrospective, descriptive-analytical study. The target group of our research involved 209 patients with DM, in whom AVF was created for HD. We recorded demographic and gender characteristics, location and type of AVF at the time of creation, type of anastomosis, data on the initial (a)function of the fistula, HD catheter placement, and blood pressure. Before the operation, Doppler ultrasound of the blood vessels was performed, and intraoperatively, the lumen of the artery and vein used to form the AVF was measured. We analyzed laboratory variables that were routinely controlled in our institution.
Results. Diabetics with successful maturing fistula significantly more often had proximally located AVF (p = 0.004), end-to-side anastomosis type (p = 0.036), and initial function (p = 0.001). In a univariate analysis, the brachiocephalic location of AVF (p = 0.004), end-to-side type of anastomosis (p = 0.039), and initial function of AVF (p = 0.001) were the predictive parameters of AVF maturation. Multivariable statistical analysis showed that brachiocephalic localization of AVF (p=0.021), end-to-side anastomosis type (p = 0.004), and initial function of AVF (p = 0.001) are the predictive parameters of AVF maturation in diabetics.
Conclusion. Predictive parameters of fistula maturation, in patients with DM in our study, are the initial function of AVF, brachiocephalic location, and end-to-side anastomosis.

 Keywords: arteriovenous fistula, hemodialysis, diabetes mellitus, maturation, predictive parameters

 

 Corresponding author:
  Radojica Stolić
e-mail: radsto@ptt.rs