Hemoglobin A1c levels do not predict primary arteriovenous fistula failure in hemodialysis patients

Abstract

Objectives: In this study, we aimed to assess whether higher preoperative levels of glycated hemoglobin (HbA1c) could predict primary arteriovenous fistula (AVF) failure and to investigate the effect of diabetes mellitus on primary arteriovenous failure. Patients and methods: Between July 2018 and August 2019, a total of 127 newly created AVFs in 117 patients (67 males, 50 females; mean age: 62.4±12.2 years; range, 18 to 86 years) who underwent primary AVF operation in our cardiovascular surgery clinic were retrospectively analyzed. Medical data were obtained from the institutional database. Arteriovenous fistula failure was evaluated during follow-up. Results: Primary AVF failure was seen in 24 (18.9%) patients. Patients with diabetes mellitus had a higher ratio of failure compared to those without (62.5% vs. 38.8%, respectively; p=0.035). After adjustment, diabetes mellitus was not found to be an independent risk factor for AVF failure (p>0.05). There was no significant correlation between HbA1c levels and fistula failure (p>0.05). Conclusion: Our study results suggest that diabetes is associated with AVF failure, but it is not an independent risk factor for AVF failure. Higher HbA1c levels fail to predict AVF failure.