Clinical Predictors of Arteriovenous Fistula Revision in Chronic Kidney Disease: The Role of Diabetes and Renal Function

Akbaş A., Cebe T., Yıldız B.

Bağcılar Tıp Bülteni, cilt.50455, ss.50455-50456, 2026 (TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 50455
  • Basım Tarihi: 2026
  • Doi Numarası: 10.4274/bmb.galenos.2026.50455
  • Dergi Adı: Bağcılar Tıp Bülteni
  • Derginin Tarandığı İndeksler: TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.50455-50456
  • Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: This study aimed to identify clinical and biochemical risk factors associated with the need for arteriovenous fistula (AVF) revision in patients with chronic kidney disease (CKD). Method: This retrospective cohort study reviewed 80 patients with CKD who underwent AVF creation between January 2023 and June 2025. Patients were categorized into revision (n=26) and non-revision (n=54) groups. Comparative analyses evaluated variables, including diabetes, hypertension, preoperative creatinine, duration of CKD, smoking, peripheral artery disease, and anticoagulant use. Results: No significant differences were observed between groups with respect to age, gender, hypertension, CKD duration, or fistula type (p>0.05). However, diabetes incidence (69% vs. 41%; p=0.02) and mean creatinine levels (7.2±3.8 vs. 6.0±3.1 mg/dL; p=0.04) were significantly higher in the revision group. Diabetes increased the risk of revision 3.2-fold (odds ratio: 3.2, 95% confidence interval: 1.2-8.6). Furthermore, a subgroup analysis (n=44) with preoperative Doppler ultrasound data revealed no significant differences in mean arterial (2.39±0.72 vs. 2.70±0.91 mm; p=0.308) or venous diameters (2.26±0.53 vs. 2.63±0.85 mm; p=0.224) between non-revision and revision groups. Conclusion: Diabetes and elevated creatinine levels significantly increase the need for AVF revision in CKD patients. A preoperative creatinine level >5.8 mg/dL is an important indicator of high risk of fistula dysfunction. These patients should be more closely monitored, and proactive approaches should