Related Experiment Video
Updated: Jun 2, 2026
A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
The primary arteriovenous fistula failure-a comparison between diabetic and non-diabetic patients: glycemic control
1Department of Nephrology, Zonguldak Atatürk State Hospital, Mesrutiyet Mah, Mustafa türkcelik Sok, Büsra Sitesi C Blok, 67100 Zonguldak, Turkey. afsarbrs@yahoo.com
Insights
Poor glycemic control, indicated by HbA1c levels of 7% or higher, significantly increases the risk of primary arteriovenous fistula (AVF) failure in diabetic patients undergoing hemodialysis. This highlights the importance of managing blood sugar to improve AVF outcomes.
Area of Science:
- Nephrology
- Vascular Surgery
- Endocrinology
Background:
- Diabetes mellitus is a known risk factor for vascular complications.
- Previous studies have yielded conflicting results regarding the impact of diabetes on primary arteriovenous fistula (AVF) failure.
- Glycemic control, measured by hemoglobin A1c (HbA1c), is a key indicator of diabetes management.
Purpose of the Study:
- To investigate the independent association between glycemic control (HbA1c) and primary AVF failure in patients undergoing hemodialysis.
- To determine if poor glycemic control is a significant predictor of AVF complications before the first successful cannulation.
Main Methods:
- Retrospective analysis of sociodemographic, clinical, and laboratory data from pre-AVF surgery medical records.
- Categorization of patients into non-diabetic (Group 1), diabetic with HbA1c <7% (Group 2), and diabetic with HbA1c ≥7% (Group 3).
- Definition of primary AVF failure as AVF complication before the first successful hemodialysis cannulation.
Main Results:
- A total of 233 patients were included: 160 non-diabetic and 73 diabetic.
- Primary AVF failure occurred in 31.8% of all patients.
- The incidence of primary AVF failure was significantly higher in diabetic patients with HbA1c ≥7% (52.8%) compared to non-diabetic patients (27.5%) and diabetic patients with HbA1c <7% (29.7%).
Conclusions:
- Poor glycemic control (HbA1c ≥7%) is an independent risk factor for primary AVF failure in diabetic patients.
- Effective glycemic management may be crucial in preventing AVF failure among diabetic individuals undergoing hemodialysis.
- Differences in AVF failure rates between diabetic and non-diabetic patients may be partly explained by glycemic control levels.
Objectives:
Presence of diabetes mellitus has been shown to be related with the occurrence of primary arteriovenous fistula (AVF) failure in some but not in all studies. In the current study, we examined whether glycemic control as evaluated by HbA1c is independently related with primary AVF failure.
Methods:
We recorded sociodemographic, clinical, and laboratory parameters of the patients from medical records and hospital charts prior to AVF surgery. Primary AVF failure was described as a complication of the AVF before the first successful cannulation for HD treatment.
Results:
Our study comprised of 160 non-diabetic (Group1) and 73 diabetic patients. Among diabetic patients, 37 had HbA1c values <7% (Group 2) and 36 patients had HbA1c values ≥7% (Group 3). In total, 74 (31.8%) patients had a history of primary AVF failure. The percentages of primary AVF failure were 27.5, 29.7, and 52.8% in Group 1, Group 2, and Group 3, respectively (P: 0.013). The percentage of patients with primary AVF failure was significantly lower in Group 1 and Group 2 than in Group 3 (P:0.003 and P:0.045, respectively). There was no difference with respect to primary AVF failure between Group 1 and Group 2 patients.
Conclusions:
We suggest that poor glycemic control as assessed by HbA1c may be an important factor for the development of primary AVF failure among diabetic subjects. It is possible that differences with respect to AVF failure between diabetic and non-diabetic patients may be partly attributed to glycemic control.
Related Concept Videos
01:28Diabetic Nephropathy
01:27Diabetic Retinopathy
01:25Hemodialysis I: Introduction
01:22Complications of Diabetes Mellitus
01:31Diabetic Foot Ulcer
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...