Impact of Serum Albumin Levels on Arterio-Venous Fistula Maturation in End-Stage Renal Disease Patients with Diabetes Mellitus
AVF Maturation in Hemodialysis Patients
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https://doi.org/10.5281/zenodo.7562218Keywords:
arteriovenous fistula, diabetes mellitus, hypoalbuminemia, hemodialysisAbstract
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: This single-center observational study was carried out using the data of 131 hemodialysis patients. 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 period was described as the interval between the creation and cannulation time of AVF providing a minimum of 250 ml/min blood flow during the hemodialysis session (week). The demographic 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 albumin level was lower (3.50±0.44 vs 3.84±0.32) during AVF creation in the diabetic group; p<0.001. A negative correlation was observed between preoperative 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.
References
Ghaderian SB, Hayati F, Shayanpour S, Beladi Mousavi SS. Diabetes and end-stage renal disease; a review article on new concepts. J Renal Inj Prev. 2015;4(2):28-33. Published 2015 Jun 1. doi:10.12861/jrip.2015.07
Narres M, Claessen H, Droste S, et al. The Incidence of End-Stage Renal Disease in the Diabetic (Compared to the Non-Diabetic) Population: A Systematic Review. PLoS One. 2016;11(1):e0147329. Published 2016 Jan 26. doi:10.1371/journal.pone.0147329
Haller C. Hypoalbuminemia in renal failure: pathogenesis and therapeutic considerations. Kidney Blood Press Res. 2005;28(5-6):307-310. doi:10.1159/000090185
Zhang J, Zhang R, Wang Y, et al. The Level of Serum Albumin Is Associated with Renal Prognosis in Patients with Diabetic Nephropathy. J Diabetes Res. 2019;2019:7825804. Published 2019 Feb 17. doi:10.1155/2019/7825804
Shah NR, Dumler F. Hypoalbuminaemia--a marker of cardiovascular disease in patients with chronic kidney disease stages II-IV. Int J Med Sci. 2008;5(6):366-370. doi:10.7150/ijms.5.366
Nakao T, Matsumoto H, Hidaka H, et al. Serum albumin levels and prognosis after commencing chronic dialysis in diabetic patients with end-stage renal failure Nihon Jinzo Gakkai Shi. 2002;44(1):34-43.
Cueto Manzano AM. Hipoalbuminemia en diálisis. Es marcador desnutrición o de inflamación? [Hypoalbuminemia in dialysis. Is it a marker for malnutrition or inflammation?]. Rev Invest Clin. 2001;53(2):152-158.
Cooper BA, Penne EL, Bartlett LH, Pollock CA. Protein malnutrition and hypoalbuminemia as predictors of vascular events and mortality in ESRD. Am J Kidney Dis. 2004;43(1):61-66. doi:10.1053/j.ajkd.2003.08.045
Inagaki E, Farber A, Eslami MH, et al. Preoperative hypoalbuminemia is associated with poor clinical outcomes after open and endovascular abdominal aortic aneurysm repair. J Vasc Surg. 2017;66(1):53-63.e1. doi:10.1016/j.jvs.2016.10.110
Roche M, Law TY, Kurowicki J, et al. Albumin, Prealbumin, and Transferrin May Be Predictive of Wound Complications following Total Knee Arthroplasty. J Knee Surg. 2018;31(10):946-951. doi:10.1055/s-0038-1672122
Chahrour MA, Kharroubi H, Al Tannir AH, Assi S, Habib JR, Hoballah JJ. Hypoalbuminemia is Associated with Mortality in Patients Undergoing Lower Extremity Amputation. Ann Vasc Surg. 2021;77:138-145. doi:10.1016/j.avsg.2021.05.047
Conte MS, Nugent HM, Gaccione P, Roy-Chaudhury P, Lawson JH. Influence of diabetes and perivascular allogeneic endothelial cell implants on arteriovenous fistula remodeling. J Vasc Surg. 2011;54(5):1383-1389. doi:10.1016/j.jvs.2011.05.005
Miller PE, Tolwani A, Luscy CP, et al. Predictors of adequacy of arteriovenous fistulas in hemodialysis patients. Kidney Int. 1999;56(1):275-280. doi:10.1046/j.1523-1755.1999.00515.x
Pisoni RL, Young EW, Dykstra DM, et al. Vascular access use in Europe and the United States: results from the DOPPS. Kidney Int. 2002;61(1):305-316. doi:10.1046/j.1523-1755.2002.00117.x
Hartge MM, Unger T, Kintscher U. The endothelium and vascular inflammation in diabetes. Diab Vasc Dis Res. 2007;4(2):84-88. doi:10.3132/dvdr.2007.025
Creager MA, Lüscher TF, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part I. Circulation. 2003;108(12):1527-1532. doi:10.1161/01.CIR.0000091257.27563.32
Mugabo Y, Li L, Renier G. The connection between C-reactive protein (CRP) and diabetic vasculopathy. Focus on preclinical findings. Curr Diabetes Rev. 2010;6(1):27-34. doi:10.2174/157339910790442628
Khavanin Zadeh M, Mohammadipour S, Omrani Z. Correlation between CRP and early failure of arteriovenous fistula (AVF). Med J Islam Repub Iran. 2015;29:219. Published 2015 Jun 8.
Velloso LA, Eizirik DL, Cnop M. Type 2 diabetes mellitus--an autoimmune disease?. Nat Rev Endocrinol. 2013;9(12):750-755. doi:10.1038/nrendo.2013.131
Kaygin MA, Halici U, Aydin A, et al. The relationship between arteriovenous fistula success and inflammation. Ren Fail. 2013;35(8):1085-1088. doi:10.3109/0886022X.2013.815100
Gagliardi GM, Rossi S, Condino F, et al. Malnutrition, infection and arteriovenous fistula failure: is there a link?. J Vasc Access. 2011;12(1):57-62. doi:10.5301/jva.2010.5831
Khavanin Zadeh M, Gholipour F, Hadipour R. The effect of hemoglobin level on arteriovenous fistula survival in Iranian hemodialysis patients. J Vasc Access. 2008;9(2):133-136.
Gheith OA, Kamal MM. Risk factors of vascular access failure in patients on hemodialysis. Iran J Kidney Dis. 2008;2(4):201-207.
Garrancho JM, Kirchgessner J, Arranz M, et al. Haemoglobin level and vascular access survival in haemodialysis patients. Nephrol Dial Transplant. 2005;20(11):2453-2457. doi:10.1093/ndt/gfi027
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