The effect of hematological tests on fistula maturation in end-stage renal disease patients with radiocephalic arteriovenous fistula

Aims: Arteriovenous fistulas (AVF) are the most commonly used vascular access route for hemodialysis (HD) in patients with end-stage renal disease. The most significant cause of AVF dysfunction is stenosis and post-stenotic thrombosis. Fistula stenosis arises from neointimal hyperplasia and various inflammatory factors. Several inflammatory markers have been studied in relation to AVF loss. This study aims to provide a comprehensive perspective on this globally prevalent health issue by examining the association between the continuity of surgically created AVFs and the patients' clinical factors, inflammatory markers, and biochemical parameters. Methods: A total of 146 patients were included in the study. All patients underwent preoperative examination of the upper extremity arterial and venous systems to confirm normal circulation. Patients with suitable arterial and venous structures underwent radiocephalic AVF creation at the wrist level. AVFs that achieved adequate flow and allowed for HD were considered matured. Results: Of the patients, 83 were male and 63 were female. The mean age of the patient group was 58.9 ± 11.41 years, with a minimum age of 30 and a maximum of 77 years. Male sex, low body mass index (BMI), antiplatelet use, and low neutrophil-to-lymphocyte ratio (NLR) and red cell distribution width (RDW) values were positively associated with AVF maturation. However, age, smoking status, type of anesthesia, diabetes, hypertension, and other blood parameters were not significantly associated with AVF maturation. Conclusion: Our study demonstrated that low maturation rates of AVFs were associated with high NLR and RDW values. In addition, antiplatelet use, male sex, and low BMI were found to be associated with AVF maturation.