Comparison of Primary Failure Rates for Radiocephalic, Brachiocephalic and Brachiobasilic Fistulas Between Patients of Diabetes and Non-Diabetes with Chronic Kidney Disease

Authors

  • Shafi ullah Department of Vascular Surgery, Combined Military Hospital, Peshawar/National University of Medical Sciences (NUMS) Pakistan
  • Nauman Imtiaz Department of Vascular Surgery, Combined Military Hospital, Peshawar/National University of Medical Sciences (NUMS) Pakistan
  • Sana Ullah Department of Vascular Surgery, Combined Military Hospital, Peshawar/National University of Medical Sciences (NUMS) Pakistan
  • Abdul Rehman Arshad Department of Nephrology, Combined Military Hospital, Peshawar/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.8514

Keywords:

Diabetes, End-stage renal disease, Haemodialysis, Haemodialysis access, Surgery

Abstract

Objective: To compare primary failure rates for radiocephalic, brachiocephalic and brachiobasilic fistulas between patients with and without diabetes mellitus.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Vascular Surgery, Combined Military Hospital, Peshawar Pakistan Aug 2020 to Mar 2022.
Methodology: Patients with chronic kidney disease referred for arteriovenous fistula surgery were included. Groups of patients with and without diabetes were age and gender-matched. Pre-operative ultrasound mapping was used for sitting,with a 3 mm diameter outflow vein set as the minimum criterion. End-to-side anastomosis using a parachute technique was performed. Patients were followed up at two, four and six weeks after surgery to assess the functional status of fistulas clinically.

Results: There were 172 patients, including 71 with diabetes mellitus. The mean age was 54.67±20.56 years. Overall, there was no difference between the two groups in rates of primary fistula failure at six weeks 9(12.67%) vs 8(7.92%), p=0.304). Brachiocephalic fistulas were made in a greater proportion of patients with diabetes as compared to those without diabetes. At six weeks, 5(10.64%) of these amongst the former were non-functional, as compared to none in the letter group (p=0.024). There was no difference in radiocephalic and brachiobasilic fistula maturity rates between the two groups at the end of the sixth postoperative week.

Conclusion: Diabetes mellitus is associated with higher primary failure rates in brachiocephalic fistulas, but the outcomes are the same for radiocephalic and brachiobasilic fistulas as compared to patients without diabetes.

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References

Lv JC, Zhang LX. Prevalence and disease burden of chronic

kidney disease. Adv Exp Med Biol 2019; 1165: 3-15.

https://doi.org/10.1007/978-981-13-8871-2_1

Qayyum A. Peritoneal dialysis in Pakistan: an insider’s view.

State of affairs and planning? Pak J Kidney Dis 2020; 4(Suppl 1):

-10. https://doi.org/10.53778/pjkd42155

Arshad AR, Fahad M, Begum M, Ahmad T, Khan I. Is missing

haemodialysis associated with short term morbidity and

mortality in end stage renal disease? Annals King Edward Med

Uni 2021; 27(4): 530-534.

https://doi.org/10.21649/akemu.v27i4.4886

Siyar F, Jamil M, Ali K, Latif H, Pervaiz H, Kharl RA. Threat

analysis of reasons leading to failure of permanent

heamodialysis access. Pak Armed Forces Med J 2021; 71(3): 861-

http://doi.org/10.51253/pafmj.v71i3.4797

Yan Y, Ye D, Yang L, Wen Ye, Dandan Zhan, Li Zhang, et al. A

meta-analysis of the association between diabetic patients and

AVF failure in dialysis. Ren Fail 2018; 40(1): 379-383.

https://doi.org/10.1080/0886022x.2018.1456464

Jeong S, Kwon H, Chang JW, Kim MJ, Ganbold K, Han Y, et al.

Comparison of outcomes between type 2 diabetic and nondiabetic incident hemodialysis patients with functioning

arteriovenous fistulas. Medicine 2019; 98(48): e18216.

https://doi.org/10.1097%2FMD.0000000000018216

Morris AA, Patel RS, Binongo JN, Poole J, Al Mheid I, Ahmed Y,

et al. Racial differences in arterial stiffness and microcirculatory

function between Black and White Americans. J Am Heart Assoc

; 2(2): e002154. https://doi.org/10.1161/jaha.112.002154

Keser BN, Kaya F, Sandal V, Kırman ÜN, Tutal MR, Kocaaslan

C, et al. Hemoglobin A1c levels do not predict primary

arteriovenous fistula failure in hemodialysis patients. Cardiovasc

Surg Int 2021; 8(3): 139-144.

http://doi.org/ 10.5606/e-cvsi.2021.1161

Rocha-Singh KJ, Zeller T, Jaff MR. Peripheral arterial

calcification: prevalence, mechanism, detection, and clinical

implications. Catheter Cardiovasc Interv 2014; 83(6): E212-220.

https://doi.org/10.1002/ccd.25387

Lilly MP, Lynch JR, Wish JB, Huff ED, Chen SC, Armistead NC,

et al. Prevalence of arteriovenous fistulas in incident

hemodialysis patients: correlation with patient factors that may

be associated with maturation failure. Am J Kidney Dis 2012;

(4): 541-549. https://doi.org/10.1053/j.ajkd.2011.11.038

Nawaz S, Ali S, Shahzad I, Baloch MU. Arterio venous fistula

experience at a tertiary care hospital in Pakistan. Pak J Med Sci

; 29(1): 161-165.

Tng ARK, Lee KG, Tan RY, Pang SC, Foo MWY, Choong HL, et

al. Validation of the failure to maturation equation and proposal

for a novel scoring system for arteriovenous fistula maturation in

multiethnic Asian haemodialysis patients. J Vasc Access 2020;

(2): 169-175. https://doi.org/10.1177/1129729819865463

Siddiqui MA, Ashraff S, Santos D, Rush R, Carline T, Raza Z.

Predictive parameters of arteriovenous fistula maturation in

patients with end-stage renal disease. Kidney Res Clin Pract

; 37(3): 277-286.

https://doi.org/10.23876/j.krcp.2018.37.3.277

Gupta A, Kumar V, Peswani AR, Suresh A. Outcomes of

arteriovenous fistula creation in patients undergoing

hemodialysis: an Indian experience. Cureus 2022; 14: e20921.

https://doi.org/10.7759%2Fcureus.20921

Khan S, Ziauddin M, Fazle-Wahab M, Ali M, Hayat N, Arif S.

Outcome of end to side Arterio-venous Fistula for chronic

hemodialysis patients at Nawaz Sharif Kidney Hospital Swat: A

cross sectional study. J Saidu Med Coll Swat 2019; 9(2): 238-242.

https://doi.org/10.52206/jsmc.2019.9.2.%25p

Arif A, Haadi O, Bhatti AM, Syed SHA, Baig ZF, Cheema AH.

Audit of vascular access surgery in a tertiary care hospital. Pak

Armed Forces Med J 2022; 72(1): 155-158.

https://doi.org/10.51253/pafmj.v72i1.5416

Jin DC, Yun SR, Lee SW, Han SW, Kim W, Park J, et al. Current

characteristics of dialysis therapy in Korea: 2016 registry data

focusing on diabetic patients. Kidney Res Clin Pract 2018; 37(1):

-29. https://doi.org/10.23876%2Fj.krcp.2018.37.1.20

Janeckova J, Bachleda P, Utikal P. Evaluating the effectiveness of

arterio venous fistula creation strategy in diabetics. Clin Surg

; 3: 2132.

Wan ZM, Hu B, Lai QQ, Gao XJ, Tu B, Zhou Y, et al. Radial

artery diameter and age related functional maturation of the

radio-cephalic arteriovenous fistula. BMC Nephrol 2020; 21(1):

https://doi.org/10.1186/s12882-020-01883-w

Yap YS, Chi WC, Lin CH, Liu YC, Wu YW. Association of early

failure of arteriovenous fistula with mortality in hemodialysis

patients. Sci Rep 2021; 11(1): 5699.

https://doi.org/10.1038%2Fs41598-021-85267-6

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Published

29-04-2024

How to Cite

1.
ullah S, Imtiaz N, Ullah S, Arshad AR. Comparison of Primary Failure Rates for Radiocephalic, Brachiocephalic and Brachiobasilic Fistulas Between Patients of Diabetes and Non-Diabetes with Chronic Kidney Disease. Pak Armed Forces Med J [Internet]. 2024 Apr. 29 [cited 2024 May 24];74(2):415-9. Available from: https://pafmj.org/PAFMJ/article/view/8514

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