Mohamed Eltantawy IbrahIm
Professor
The Impact of Arteriovenous Access Placement on Estimated Glomerular Filtration Rate in Diabetic, Non Diabetic Chronic Kidney Diseases Pre-dialysis Stage 5
Egyptian journal of hospital medicine • 2024
Publication Information
Authors
Shaimaa Mostafa Mohamed, ELMetwally L. ELShahawy, Mohamed E. Ibrahim, Salma Essam Eldin Abdelaziz and Ahmed E. Mansour
Keywords
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Journal
Egyptian journal of hospital medicine
Publisher
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Volume
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Issue
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Pages
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publication.type
Local
Paper Link
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Supplementary Materials
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Abstract
Background: Chronic kidney disease (CKD) represents a significant and often deteriorating condition that can lead to
the ultimate need for hemodialysis due to end-stage renal disease. In patients with CKD, creating arteriovenous access
(AVA) is a routine surgical procedure.
Objective: This study aimed to explore how AVA surgery affects the estimated glomerular filtration rate (eGFR) in
both diabetic and non-diabetic CKD patients at pre-dialysis stage 5, emphasizing the timing and impact on renal
functionality.
Patients and Methods: A prospective cohort study was conducted on 100 CKD patients who underwent AVA surgery.
These patients were divided into diabetic and non-diabetic groups for comparison. Comprehensive clinical evaluations,
lab tests, and subsequent appointments were conducted for thorough analysis.
Results: In the diabetic cohort (Group 1), there was a notable reduction in eGFR, decreasing from 11.05 ± 0.81
mL/min/1.73 m² one month prior to AVA formation to 10.00 ± 0.43 mL/min/1.73 m² three months afterward (p < 0.001).
There was also an increase in serum creatinine from 6.03 ± 0.96 mg/dL to 6.80 ± 0.99 mg/dL (p < 0.001), and urea
levels escalated from 211.15 ± 33.6 mg/dL to 237.85 ± 34.78 mg/dL (p < 0.001). Conversely, in the non-diabetic cohort
(Group 2), a meaningful reduction in eGFR was observed, from 12.07 ± 0.87 mL/min/1.73 m² before AVA formation
to 11.84 ± 0.52 mL/min/1.73 m² after three months (p = 0.004).
Conclusions: The findings indicated that the insertion of AVA in patients with stage 5 CKD pre-dialysis, especially
those with diabetes, significantly decreased eGFR, accompanied by rises in serum creatinine and urea levels.
the ultimate need for hemodialysis due to end-stage renal disease. In patients with CKD, creating arteriovenous access
(AVA) is a routine surgical procedure.
Objective: This study aimed to explore how AVA surgery affects the estimated glomerular filtration rate (eGFR) in
both diabetic and non-diabetic CKD patients at pre-dialysis stage 5, emphasizing the timing and impact on renal
functionality.
Patients and Methods: A prospective cohort study was conducted on 100 CKD patients who underwent AVA surgery.
These patients were divided into diabetic and non-diabetic groups for comparison. Comprehensive clinical evaluations,
lab tests, and subsequent appointments were conducted for thorough analysis.
Results: In the diabetic cohort (Group 1), there was a notable reduction in eGFR, decreasing from 11.05 ± 0.81
mL/min/1.73 m² one month prior to AVA formation to 10.00 ± 0.43 mL/min/1.73 m² three months afterward (p < 0.001).
There was also an increase in serum creatinine from 6.03 ± 0.96 mg/dL to 6.80 ± 0.99 mg/dL (p < 0.001), and urea
levels escalated from 211.15 ± 33.6 mg/dL to 237.85 ± 34.78 mg/dL (p < 0.001). Conversely, in the non-diabetic cohort
(Group 2), a meaningful reduction in eGFR was observed, from 12.07 ± 0.87 mL/min/1.73 m² before AVA formation
to 11.84 ± 0.52 mL/min/1.73 m² after three months (p = 0.004).
Conclusions: The findings indicated that the insertion of AVA in patients with stage 5 CKD pre-dialysis, especially
those with diabetes, significantly decreased eGFR, accompanied by rises in serum creatinine and urea levels.