The Predictive Factors of Arteriovenous Fistula Maturation in Patients with End-Stage Renal Disease

Background: Arteriovenous fistula (AVF) is one of most common types of vascular access used in end-stage renal disease (ESRD) patients in renal replacement therapy. Many factors can affect the maturation of AVF. This study aimed to investigate the factors that influence AVF maturation. Methods: Retrospective data of subjects who underwent the AVF procedure from May 1 to June 31, 2017 in South Ring Road Surgery Hospital were examined through medical records. Analysis of predictive models was done using logistic regression with backward stepwise procedure. Results: Mature AVF occurred in 82.8 of 87 total subjects, with average AVF maturity duration of 26.6 ± 8.30 days. There was a significant difference in the average age of the subjects with regard to AVF maturation, in that the average age in the mature group and the immature group was 52.47 ± 14.5 and 45.17 ± 10.92 years, respectively (P = 0.029, Mann-Whitney). There was no significant difference between the mature group and the immature group with regard to AVF maturation in males (P = 0.361) and some comorbid factors such as diabetes mellitus (P = 0.765), hypertension (P = 0.448), smoking history (P = 0.394), and peripheral vascular disease (P = 1.000). The majority of the AVF were located in the forearm (56.3). Arterial diameter above 2 mm resulted in a more than 4 times increase in AVF maturity (P = 0.010, odds ratio OR = 4.85, 95% confidence interval 95%CI: 1.46 16.11), while venous diameter above 2 mm (P = 0.620, OR = 0.72, 95%CI: 0.20 2.59) showed no statistically significant difference in logistic regression. Conclusions: Arterial diameter appears to be a strong predictor of AVF maturity, with outcomes being more than 4 times better with arterial diameter above 2 mm.© © 2023 Elsevier B.V., All rights reserved.