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Factors Influencing Maturation of Native Arteriovenous Fistulas
Karen Woo, Fred A. Weaver, Vincent L. Rowe.
University of Southern California, Los Angeles, CA, USA.

Objective: To determine factors influencing the maturation time of native arteriovenous fistulas.
Methods: A retrospective review was performed of hemodialysis patients from a single university-associated dialysis center from 2004-2009. Demographics, co-morbidities and insurance status were recorded. Maturation time was defined as the time from access creation until the access was able to be used regularly for hemodialysis for a period of two weeks.
Results: 249 patients were identified during the study period who had an arteriovenous fistula created that successfully matured. 104 (42%) patients were female and 145 (58%) were male. The majority of the patients were Hispanic (82%). 97 (39%) of the patients had Medicaid type insurance and 133 (53%) had Medicare. The mean age was 51. 190 (76%) of the patients had diabetes. The overall mean maturation time was 79 days. Females had a significantly longer time to fistula maturation than males (91.9 days vs 70.5 days, P 0.0028. Diabetics also had a significantly longer maturation time than non-diabetics (92.5 days vs 75.4 days, P 0.0004). Age did not have an effect on maturation time. On multivariable analysis, sex remained significant (P .007), however, diabetes lost its significance.
Conclusion: In this predominantly Hispanic hemodialysis population, females require longer fistula maturation times than males. The exact reasons for this are unknown based on this data. More study is required to determine the etiology of this gender discrepancy.


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