PATENCY RATE OF ARTERIO-VENOUS FISTULA AT WRIST AMONG DIABETIC AND NON-DIABETIC PATIENTS OF CKD-5

Arvind Mehra*, Saurabh Bawa, Sanjeev Gupta, Pamposh Raina and Pawan Kaundal

ABSTRACT

Background: Over the past three decades, diabetes mellitus is found to be most quickly spreading cause of chronic kidney disease (CKD) globally. Vessel diameter is an important predictor of patency of arterio-venous fistula (AVF) which found to alter in diabetes. Objectives: Considering the increasing role of diabetes mellitus as a cause of CKD and the challenges involved in constructing AVFs in certain groups of patients, the present study was to evaluated the patency rate of AVF among diabetic and non-diabetic patients of CKD-5. Methodology: Total 131 patients of CKD-5 who required AV-fistula formation were included in this study with 73 (55.7%) non-diabetic and 58 (44.3%) diabetic cases. Sociodemographic and clinical parameters were analyzed using a pre-designed semi-structured proforma. Patency rate of AVF was assessed at 3 and 6 months follow up. Results: The mean age of the patients was 51.69 ± 14.27 years in case of non-diabetic patients and was 54.53 ± 10.24 years in case of diabetic patients with majority of males in both groups. Among total 111 survived cases at 3 month follow up, AV fistula was patent in 97 (87.4%) cases among which 60 (61.9%) were non-diabetic and 37 (38.1%) was diabetic. Among total 97 survived cases at 6 months follow up, AV fistula was patent in 75 (77.3%) cases among which 49 (65.3%) were non-diabetic and 26 (34.7%) was diabetic. Conclusion: Present study revealed that AVF was more viable in non-diabetic patients compared to the diabetes. Diabetes thus found to be contributing factor in failure of AVF among patients with CKD-5.

Keywords: Diabetes, CKD, AVF, Surgery, Patency.