Comparison of success rate of arterio-venous fistula in patients with diabetes vs non-diabetes
Introduction and objective: Definition of chronic renal disease is based on the presence of kidney damage or glomerular filtration rate (GFR 60 ml/min per 1.73 m2) for 3 months, irrespective of cause[1]. Once they are diagnosed as CKD, they are kept either on hemodialysis or peritoneal dialysis or p...
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| Language: | English |
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Society of Surgeons of Nepal
2016-07-01
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| Series: | Journal of Society of Surgeons of Nepal |
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| Online Access: | https://www.nepjol.info/index.php/JSSN/article/view/15333 |
| _version_ | 1818772915980599296 |
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| author | K Karki N Banepali S Hirachand R Mukhiya RKN Shrestha |
| author_facet | K Karki N Banepali S Hirachand R Mukhiya RKN Shrestha |
| author_sort | K Karki |
| collection | DOAJ |
| description | Introduction and objective: Definition of chronic renal disease is based on the presence of kidney damage or glomerular filtration rate (GFR 60 ml/min per 1.73 m2) for 3 months, irrespective of cause[1]. Once they are diagnosed as CKD, they are kept either on hemodialysis or peritoneal dialysis or patient undergo renal transplant.[2,3] With this research we may prove that even in a similar circumstances failure rate of AVF is more in diabetes patient.
Materials and Methods: Total 50 patients of either gender were taken in this study. Inclusion criteria: CRF with GFR <30ml/min. Arterial diameter >1.5mm and venous diameter >2mm. Preoperative radial artery blood flow >30cm/min. Exclusion criteria: arterial diameter <1.5mm venous diameter <2mm.Written consent was taken from the patient. After preoperative workup surgery was done by 1st author. Arterio-venous fistula was scanned by color Doppler imaging after 4 weeks.
Result: There were 31[62%] male, 19[38%] female. Mean age of patients was 55.8 years. 18[36%] were dialysis dependent. Cause of renal failure were diabetes 16(32%), unknown 15(30%), glomerulonephritis 8[16%] and obstructive uropathy 3[6%]. Mean internal diameter of radial artery was 1.91mm [1.5-2.6] and cephalic vein 2.57mm [1.9-3.2].7 patients had swelling of arm, 5 patients has surgical site infections and 15 patients had primary failure; 11 were from diabetic group and 4 from non-diabetic group. Mean duration of surgery was 60.95 minutes [50-75]. Average preoperative velocity in radial artery was 32.94[30-39]cm/sec. Average flow of blood at the end of 4 weeks was 461.42ml/min [0-654]. Between two groups failure rate was significantly high in diabetic patients [p = 0.02]. Failure rate was significantly higher in patients with diabetes more than 10
years [p=0.01].
Conclusion: Failure rate of arterio-venous fistula is significantly high in diabetic patients. |
| first_indexed | 2024-12-18T10:16:57Z |
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| id | doaj.art-50932c2bf1b4499ea40253ac66b5d3e2 |
| institution | Directory Open Access Journal |
| issn | 1815-3984 2392-4772 |
| language | English |
| last_indexed | 2024-12-18T10:16:57Z |
| publishDate | 2016-07-01 |
| publisher | Society of Surgeons of Nepal |
| record_format | Article |
| series | Journal of Society of Surgeons of Nepal |
| spelling | doaj.art-50932c2bf1b4499ea40253ac66b5d3e22022-12-21T21:11:16ZengSociety of Surgeons of NepalJournal of Society of Surgeons of Nepal1815-39842392-47722016-07-0118310.3126/jssn.v18i3.15333Comparison of success rate of arterio-venous fistula in patients with diabetes vs non-diabetesK KarkiN BanepaliS HirachandR MukhiyaRKN ShresthaIntroduction and objective: Definition of chronic renal disease is based on the presence of kidney damage or glomerular filtration rate (GFR 60 ml/min per 1.73 m2) for 3 months, irrespective of cause[1]. Once they are diagnosed as CKD, they are kept either on hemodialysis or peritoneal dialysis or patient undergo renal transplant.[2,3] With this research we may prove that even in a similar circumstances failure rate of AVF is more in diabetes patient. Materials and Methods: Total 50 patients of either gender were taken in this study. Inclusion criteria: CRF with GFR <30ml/min. Arterial diameter >1.5mm and venous diameter >2mm. Preoperative radial artery blood flow >30cm/min. Exclusion criteria: arterial diameter <1.5mm venous diameter <2mm.Written consent was taken from the patient. After preoperative workup surgery was done by 1st author. Arterio-venous fistula was scanned by color Doppler imaging after 4 weeks. Result: There were 31[62%] male, 19[38%] female. Mean age of patients was 55.8 years. 18[36%] were dialysis dependent. Cause of renal failure were diabetes 16(32%), unknown 15(30%), glomerulonephritis 8[16%] and obstructive uropathy 3[6%]. Mean internal diameter of radial artery was 1.91mm [1.5-2.6] and cephalic vein 2.57mm [1.9-3.2].7 patients had swelling of arm, 5 patients has surgical site infections and 15 patients had primary failure; 11 were from diabetic group and 4 from non-diabetic group. Mean duration of surgery was 60.95 minutes [50-75]. Average preoperative velocity in radial artery was 32.94[30-39]cm/sec. Average flow of blood at the end of 4 weeks was 461.42ml/min [0-654]. Between two groups failure rate was significantly high in diabetic patients [p = 0.02]. Failure rate was significantly higher in patients with diabetes more than 10 years [p=0.01]. Conclusion: Failure rate of arterio-venous fistula is significantly high in diabetic patients.https://www.nepjol.info/index.php/JSSN/article/view/15333CRFarterio-venous fistuladiabetes mellitus |
| spellingShingle | K Karki N Banepali S Hirachand R Mukhiya RKN Shrestha Comparison of success rate of arterio-venous fistula in patients with diabetes vs non-diabetes Journal of Society of Surgeons of Nepal CRF arterio-venous fistula diabetes mellitus |
| title | Comparison of success rate of arterio-venous fistula in patients with diabetes vs non-diabetes |
| title_full | Comparison of success rate of arterio-venous fistula in patients with diabetes vs non-diabetes |
| title_fullStr | Comparison of success rate of arterio-venous fistula in patients with diabetes vs non-diabetes |
| title_full_unstemmed | Comparison of success rate of arterio-venous fistula in patients with diabetes vs non-diabetes |
| title_short | Comparison of success rate of arterio-venous fistula in patients with diabetes vs non-diabetes |
| title_sort | comparison of success rate of arterio venous fistula in patients with diabetes vs non diabetes |
| topic | CRF arterio-venous fistula diabetes mellitus |
| url | https://www.nepjol.info/index.php/JSSN/article/view/15333 |
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