Impact of Serum Albumin Levels on Arterio-Venous Fistula Maturation in End-Stage Renal Disease Patients with Diabetes Mellitus "Arteriovenous Fistula Maturation in Hemodialysis Patients"

Background: Diabetes mellitus (DM) is a well-known risk factor for the prolongation of arterio-venous fistula (AVF) maturation and hypoalbuminemia. In this study, we studied the impact of the serum albumin levels during AVF creation on AVF maturation duration, in diabetic patients.

Material and Methods: In our center, this single-center observational study was carried out using the data of 131 hemodialysis patients who received hemodialysis in 2021. Sixty-seven individuals with AVF were included in the study and were divided into two groups; diabetics and non-diabetics. Serum albumin levels during AVF creation were noted. The maturation time was accepted as; the time of cannulation of AVF which provided a minimum 250 ml/min blood flow during the hemodialysis session (week). The epidemiological and clinical features of the individuals were noted and compared.

Results: Twenty-five individuals were in the diabetic and 42 were in the non-diabetic group. Serum albümin level was lower (3.50±0.44 vs 3.84±0.32)  in the diabetic group, p<0.001. A negative correlation was observed between serum albumin level and AVF maturation time, p=0.003 and r=0,132. Additionally, maturation duration was significantly higher among diabetics (6.6 vs 5.1 weeks). Serum CRP levels were similar between the two groups (p=0.057). 

Conclusion: Longer AVF maturation time in diabetic patients is closely related to low serum albumin levels. Low serum levels of albumin should be considered when evaluating ESRD patients with DM for AVF creation.