Background: Diabetes mellitus accelerates cardiovascular deterioration in chronic kidney disease, but it is unclear whether it adds stiffness to the central arteries or affects the peripheral arteriovenous fistula (AVF) of hemodialysis patients. Objective: To compare central and peripheral pulse wave velocity (cfPWV, faPWV), renal resistive index (RI), and radiocephalic AVF diameter and volume flow between diabetic and non-diabetic hemodialysis patients. Methods: This analytical cross-sectional study included 120 prevalent hemodialysis patients (22 diabetic, 98 non-diabetic) at Dr. M. Djamil General Hospital in 2025. One blinded sonographer measured the vascular parameters by Doppler ultrasonography. Groups were compared with t-tests and chi-square tests, with 95% confidence intervals and Cohen's d. Results: Diabetic patients were older (56.4 ± 8.1 vs. 50.6 ± 9.4 years; p = 0.004) and had lower diastolic blood pressure (73.27 ± 9.84 vs. 79.72 ± 10.15 mmHg; p = 0.008). cfPWV (2.89 ± 0.57 vs. 2.90 ± 0.61 m/s; p = 0.941), faPWV (3.34 ± 0.73 vs. 3.15 ± 0.69 m/s; p = 0.236), and mean RI (0.825 ± 0.029 vs. 0.818 ± 0.033; p = 0.341) did not differ. AVF diameter was smaller in diabetic patients (1.74 ± 0.63 vs. 2.36 ± 0.74 mm; p < 0.001; Cohen's d = −0.86), whereas flow did not differ significantly (3489 ± 1018 vs. 3063 ± 945 mL/min; p = 0.072). Conclusion: Diabetes was associated with a smaller AVF diameter but not with higher central or peripheral stiffness or renal RI. Given the cross-sectional, unadjusted design, adjusted longitudinal studies are needed.
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