Early Failure of Arteriovenous Fistula (AVF): The Effect of Diabetes and Hypertension in a Cross-Sectional Study

Amir Bahrami-Ahmadi; Morteza Khavanin Zadeh; Haleh Chehrehgosha; Mohsen Abbasi

doi:10.47176/mjiri.36.89

Early Failure of Arteriovenous Fistula (AVF): The Effect of Diabetes and Hypertension in a Cross-Sectional Study

Med J Islam Repub Iran. 2022 Aug 8:36:89. doi: 10.47176/mjiri.36.89. eCollection 2022.

Authors

Amir Bahrami-Ahmadi¹, Morteza Khavanin Zadeh², Haleh Chehrehgosha³, Mohsen Abbasi⁴

Affiliations

¹ Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.
² Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
³ Hazrat Rasoul Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
⁴ Department of Emergency Medicine, Hasheminejad Kidney Center, Hazrat Rasoul Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Identification and control of clinical predictors of arteriovenous (AVF) failure can improve the long-term outcome of hemodialysis patients. The effects of these factors on the outcome of AVF are not still clear. So, we aimed this study to compare the effect of hypertension and diabetes on early failure of AVF. Methods: In this retrospective study, we evaluated 400 patients with ESRD referred to our clinic for the creation of the first AVF from July 14, 2001, through August 7, 2018. One month after AVF creation, the patients were referred to the clinic for patency control. Demographic characteristics, previous history of diabetes and hypertension, and laboratory data of all patients were recorded preoperatively. Data were entered to SPSS v.24 and Study data were analyzed with chi-square and independent student t-test. Then, early failure of AVF and its relationship with a history of diabetes and hypertension were assessed. Results: There was no statistically significant relationship between the history of diabetes and early AVF failure risk in ESRD patients (OR, 0.78; 95% CI, 0.25 to 2.43). Furthermore, the history of hypertension was significantly lower in the early failure of AVF group (OR, -2.82; 95% CI, -1.42 to -5.59). Although, this effect faded when using regression analysis (OR, -2.67; 95% CI, -0.97 to -7.36). There was a higher Body mass index in the non-early failure group (p = 0.041). There was no significant difference in age (p = 0.512), gender (p = 0.091), history of smoking (p = 0.605), treatment with insulin (p = 0.683), oral antidiabetic agents (p = 0.734), duration of diabetes (p = 0.384), and duration of hypertension (p = 0.093). Conclusion: We reported that the history of diabetes was not higher in the early failure group, while there was a lower risk of AVF failure in patients with a previous history of hypertension.

Keywords: Arteriovenous Failure (AVF); Diabetes; Early Failure; End-Stage Renal Disease (ESRD); Hypertension; Non-Early Failure; Obesity.