Volume 48, Issue 4 December 2024 JVU 484-213 | Effects of Diabetes on the Development of Arteriovenous Fistula during the First 6 Weeks-JVU 484-213 | Effects of Diabetes on the Development of Arteriovenous Fistula during the First 6 Weeks

JVU 484-213 | Effects of Diabetes on the Development of Arteriovenous Fistula during the First 6 Weeks

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The study published in the Journal for Vascular Ultrasound explores the impact of diabetes on the development of arteriovenous fistulas (AVFs) during the first six weeks after their creation. AVFs are crucial for hemodialysis in patients with kidney failure, a condition often exacerbated by diabetes. This study involved a prospective cohort of 65 patients who underwent AVF surgery at Dong Nai General Hospital in Vietnam, between April 2022 and April 2023. The cohort was split nearly evenly between patients with diabetes (33) and those without (32).<br /><br />Patients were observed using ultrasound at four stages: preoperatively, and one day, two weeks, and six weeks post-surgery. The research aimed to assess the trajectory of fistula growth in terms of diameter and blood flow rate and compare these trajectories between patients with and without diabetes. <br /><br />Results indicated that patients with diabetes were generally older and more likely to have arterial calcification. They also exhibited slower maturation rates of AVFs at different measured time points. For example, fewer patients with diabetes met the criteria for AVF maturity at day one and week two post-surgery compared to the non-diabetic cohort. By week six, all patients, regardless of diabetic status, achieved AVF maturity. The study found that measurements taken at week two were more predictive of AVF maturity by week six than those taken on day one.<br /><br />The findings underline that diabetes tends to slow the initial growth of AVFs, but the eventual maturation is comparable to that in non-diabetic patients. This suggests that while diabetes affects the early trajectory of fistula development, it does not preclude successful AVF maturation within six weeks. The study calls for further research to refine these observations, emphasizing the need for larger sample sizes and more nuanced data on diabetes management.

Keywords

diabetes

arteriovenous fistulas

AVF maturation

hemodialysis

vascular ultrasound

kidney failure

Dong Nai General Hospital

arterial calcification

prospective cohort

fistula growth