Diabetes should not dissuade arteriovenous fistula formation

Abstract

Background: Fistula maturation is a complex multifactorial process with the effect of diabetes on vessel augmentation during fistula formation remaining unclear. Variation in results has reflected in a range of clinical practice with regard to patient selection and fistula formation and so requires more study. The aim of our study was to compare outcomes of diabetic and non-diabetic patients undergoing formation of a new upper limb arteriovenous fistula (AVF) to assess whether diabetes has a prognostic effect on outcome. Methods: A retrospective cohort study analysing 339 patients looking at both radiocephalic and brachiocephalic fistula formation in diabetic and non-diabetic patients was designed, with the primary outcome being fistula failure and then time taken to mature. Results: No difference was found between diabetic and nondiabetic patients in terms of fistula failure or time to mature. Conclusions: With AVF remaining the best access for dialysis, diabetic patients should not be discouraged from being offered AVF formation as they have equivalent outcomes to non-diabetic patients.