Abstract: SA-PO0444
Comparison of Outcomes Between Arteriovenous Fistula (AVF) and Arteriovenous Graft (AVG) Surgery in Diabetic and Nondiabetic Patients
Session Information
- Dialysis: Vascular Access
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Huang, Jin, Kaiser Permanente San Francisco Medical Center, San Francisco, California, United States
- Alexander, Janet G, The Kaiser Permanente Division of Research, Oakland, California, United States
- Ukponmwan, Esosa Uwaifo, Kaiser Permanente San Francisco Medical Center, San Francisco, California, United States
- Pak, Jimmy, The Permanente Medical Group Inc, Oakland, California, United States
- Cohn, Bradley R., The Permanente Medical Group Inc, Oakland, California, United States
- Zheng, Sijie, The Permanente Medical Group Inc, Oakland, California, United States
Background
Studies have shown diabetes is a risk factor for adverse surgical outcomes and prolonged hospitalization. However, the underlying patient characteristics associated with adverse outcomes of AVF/AVG surgery remain unclear.
Methods
This retrospective study examined Kaiser Permanente Northern California adult members who underwent AVF/AVG surgery between January 1, 2013, and December 31, 2023. Pre-surgery glycemic control was measured by HgA1c. Logistic regression was used to assess association between glycemic control and 30-day post-op adverse outcomes, including infection, hematoma, occlusion, open wound, steal syndrome, MI and death.
Results
Of the 10,090 patients with advanced CKD who underwent AVF/AVG surgery, 7,574 were diabetic. Compared with non-diabetics, diabetic patients were older (Mean age: 66.1 vs. 63.6), had a higher Charlson Comorbidity score one year before surgery (Mean: 5.4 vs. 3.1); higher systolic blood pressure (Mean: 137.3 vs. 132.4) and lower diastolic BP (Mean: 68.7 vs. 72.8). Additionally, diabetic patients had higher proportions of Asian (17% vs. 13.7%) and Hispanics (23.6% vs. 19.5%).
Within 30 days post-surgery, diabetic patients were more likely to experience infection (5.4% vs. 4.1%) and MI (2% vs. 1%). There was no difference in hematoma, access occlusion, steal syndrome or death between the groups.
Among diabetic patients, infections were more common in those with higher BMI (OR 1.015, 95% CI 1.001-1.029), lower SBP (OR 0.990, 95% CI 0.984-0.995). Hematoma and open wounds occurred more in patients with lower SBP.
Conclusion
Among this diverse, contemporary cohort of patients who underwent AVF/AVG surgery, diabetic patients were older, had more comorbidities, and are associated with higher rates of infection. Further studies are needed to determine whether improved pre-surgical diabetes management can lead to better surgical outcomes.