title: Arterial disease and vascular access in diabetic patients.
abstract: OBJECTIVE
  There are conflicting reports on the effects of diabetes on the outcomes of hemodialysis access procedures. While some found no negative effects, others reported deleterious effects of diabetes on vascular access outcomes. Why is there concern about diabetes and related vascular problems on vascular access procedures? What are the differences of diabetic patients and their vasculature from that of nondiabetics? Do they have an effect on hemodialysis vascular access outcomes? We will try to find answers to these questions in light of the available evidence.
  
  
  METHODS
  Recent literature on arterial disease in diabetes and end-stage renal disease (ESRD), and the effects on vascular access outcomes were searched in order to find answers to above questions.
  
  
  RESULTS
  There are conflicting and controversial reports on the effects of preexisting vascular problems due to diabetes and chronic kidney disease (CKD) on the outcomes of hemodialysis access procedures. Diabetic vasculature, especially in patients with ESRD, has some specific problems, the most important of which seem to be the calcification and stiffening of the arteries.
  
  
  CONCLUSIONS
  Although some authors report inferior outcomes of vascular access procedures in diabetic patients, there is evidence that most of the problems encountered can be dealt with by careful patient selection, surgical skill, and experience.
authors.affiliation: Istanbul Medical Faculty, General Surgery Department, Capa, Istanbul - Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Baktiroglu
authors.affiliation: Istanbul Medical Faculty, General Surgery Department, Capa, Istanbul - Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Yanar
authors.affiliation: Istanbul Medical Faculty, General Surgery Department, Capa, Istanbul - Turkey.
authors.forename: Ibrahim H
authors.initials: IH
authors.lastname: Ozata
authors.affiliation: Istanbul Medical Faculty, General Surgery Department, Capa, Istanbul - Turkey.
authors.forename: Gizem
authors.initials: G
authors.lastname: Oner
authors.affiliation: Istanbul Medical Faculty, General Surgery Department, Capa, Istanbul - Turkey.
authors.forename: Damla
authors.initials: D
authors.lastname: Ercan
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D003925:Diabetic Angiopathies / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006435:Renal Dialysis; D012307:Risk Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D059289:Vascular Stiffness