CHARACTERISTICS OF ARTERIOVENOUS FISTULA FOR HAEMODIALYSIS IN DIABETICS AND OLDER PATIENTS
R. Stolić, S. Sovtić, V. Perić, D. Stolić, A. Jovanović, B. Mihailović, S. Milinić, B. Krdžić, S. Pajović, G. Šubarić-Gorgieva<p>Formation of vascular access in elderly and diabetic patients is burdened with many difficulties. The aim of this study was to determine the factors that older people and patients with diabetes mellitus defined as the population risk for the formation of arteriovenous fistula for hemodialysis. The study was organized as a retrospective study, a subject of interest in people older than 65 years of age and diabetes, which in four years because of the need for further treatment performed arteriovenous fistula. Analyzed the demographic structure of the patient, type of anastomosis, the use of central-venous catheters for hemodialysis, arterial blood pressure and size of the lumen of blood vessels used for anastomosis, intraoperative measured. From the laboratory analysis determined the routine hematological and biochemical parameters. In relation to the positioning of arteriovenous fistula (p=0.033), the placement of catheters for hemodialysis (p=0.0009), preventive form of vascular access (p=0.04) and values of systolic (p=0.0001) and diastolic (p=0.0001) arterial blood pressure, achieved a statistically significant difference. Patients with diabetic nephropathy, compared to the population of elderly, have a significantly higher number of leukocytes (7.5&plusmn;2.61 vs. 8.5&plusmn;3.24, p=0.03), fibrinogen level (5.57&plusmn;2.39 vs. 6.8&plusmn;1.71, p=0.036), glycemia (5.35&plusmn;1.24 vs. 7.1&plusmn;2.28, p&lt;0.0001), cholesterol (3.77&plusmn;1 , 03 vs. 4.5&plusmn;1.71, p=0.001), triglycerides (1.59 &plusmn;0.62 vs. 1.86&plusmn;0.76, p=0.009) and LDL-cholesterol (2.13&plusmn;0.76 vs. 2.42&plusmn;2.04, p=0.02). Total proteins (64&plusmn;9.98 vs. 62 &plusmn;7.4, p=0.027) and albumin (36&plusmn;34 vs. 9.55&plusmn;5.49, p=0.037) were significantly lower values in diabetics. Characteristics of older diabetics and is characterized as a risk population of patients for the creation of arterio-fistula were timely creation and position of arterio fistula, the need for placement of central-venous catheters for hemodialysis and arterial blood pressure.</p>