[Vascular access for chronic hemodialysis in diabetic patients]

Area of Science:

• Nephrology
• Vascular Surgery
• Diabetology

Background:

• Chronic kidney disease (CKD) patients often require hemodialysis.
• Vascular access is crucial for effective hemodialysis.
• Diabetic patients with uremia present unique challenges for vascular access.

Purpose of the Study:

• To evaluate vascular access complications in uremic diabetic patients undergoing chronic hemodialysis.
• To determine the short- and long-term incidences of these complications.
• To assess the efficacy of distal arteriovenous fistulae in this patient population.

Main Methods:

• Study included 33 uremic diabetic patients on chronic hemodialysis.
• 46 vascular anastomoses were created: 39 Brescia-Cimino arteriovenous fistulae and 7 PTFE grafts.
• Actuarial survival rates were calculated at one, two, and four years.

Main Results:

• The actuarial survival rates for vascular access were 88% (1 year), 79% (2 years), and 63% (4 years).
• Thrombosis was the most frequent complication observed.
• Distal arteriovenous fistulae demonstrated acceptable patency rates.

Conclusions:

• Distal arteriovenous fistulae are a suitable vascular access option for hemodialysis in diabetic patients with uremia.
• Careful monitoring is necessary to manage complications like thrombosis.
• This approach supports long-term hemodialytic treatment in this challenging cohort.