Insufficient Arteriovenous Fistulae in Hemodialysis Patients

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background: For an accurate assessment of structural changes in arteriovenous fistulae (AVF) a microscopic analysis is mandatory. Methods: 25 insufficient AVF were analyzed with the light microscope using standard histological and immunohistochemical techniques. Results: In 7 patients (28%) atherosclerotic lesions as causes of AVF insufficiency were found. The other 18 patients (72%) had an inhomogeneous spectrum of nonatherosclerotic lesions, for instance intimal hyperplasia. Conclusions: Histopathologic analysis of insufficient AVF helps clarify the underlying changes in the structure of the vessel wall.

Related collections

Most cited references 6

Record: found
Abstract: found
Article: not found

Oral anticoagulant treatment: friend or foe in cardiovascular disease?

Jan Janzen, Hermann Aebert, Cees Vermeer … (2004)

Calcification is a common complication in cardiovascular disease and may affect both arteries and heart valves. Matrix gamma-carboxyglutamic acid (Gla) protein (MGP) is a potent inhibitor of vascular calcification, the activity of which is regulated by vitamin K. In animal models, vitamin K antagonists (oral anticoagulants [OACs]) were shown to induce arterial calcification. To investigate whether long-term OAC treatment may induce calcification in humans also, we have measured the grade of aortic valve calcification in patients with and without preoperative OAC treatment. OAC-treated subjects were matched with nontreated ones for age, sex, and disease. Calcifications in patients receiving preoperative OAC treatment were significantly (2-fold) larger than in nontreated patients. These observations suggest that OACs, which are widely used for antithrombotic therapy, may induce cardiovascular calcifications as an adverse side effect.

0 comments Cited 36 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Oxidative stress and increased expression of growth factors in lesions of failed hemodialysis access.

K. Anderson, V Scivittaro, Marjan Weiss (2001)

The pathological role of oxidative stress in patients treated by hemodialysis has gained increasing recognition in recent years. Because complications related to vascular access are a major source of morbidity, immunohistochemical evidence of oxidative stress and activation of growth factors were examined in native arteriovenous (AV) fistulae (n = 11) and expanded polytetrafluoroethylene (ePTFE) grafts (n = 15) recovered from hemodialysis patients at the time of surgical revision or resection. To show the presence of oxidative stress in tissues, three markers were chosen: N(epsilon)(carboxymethyl)lysine, a structurally identified advanced glycation end product; 4-hydroxy-2,3-nonenol, a lipid peroxidation product; and redox-active transition metals bound to proteins, a source of Fenton chemistry-generated free radicals. Markers of cell growth and proliferation were endothelin-1 (ET-1), a potent mitogenic peptide implicated in the formation of intimal hyperplasia; transforming growth factor-beta (TGF-beta), a stimulus to vascular cell growth and matrix production; and platelet-derived growth factor (PDGF), a mediator of intimal hyperplasia. All specimens studied showed significant intimal hyperplasia. In general, the neointima close to the vascular lumen of the AV fistula and the pseudointima close to the lumen of the ePTFE graft were positive for oxidative stress markers. At sites of injury, especially in the presence of histological evidence of inflammation and healing, expression of oxidative markers was particularly intense. Prominent staining of PDGF was shown at sites of anastomotic hyperplasia and in neovasculature. TGF-beta was associated with proliferation or repair in both AV fistulae and ePTFE grafts. ET-1 staining was most intense in the neointima and pseudointima. This study showed histochemical colocalization of markers of oxidative stress with growth factors known to contribute to intimal hyperplasia.

0 comments Cited 35 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Flow patterns in the radiocephalic arteriovenous fistula: an in vitro study.

S. Sivanesan, T.V. How, R.A. Black … (1999)

A significant number of late failures of arteriovenous fistulae for haemodialysis access are related to the progression of intimal hyperplasia. Although the aetiology of this process is still unknown, the geometry of the fistula and the local haemodynamics are thought to be contributory factors. An in-vitro study was carried out to investigate the local haemodynamics in a model of a Cimino-Brescia arteriovenous (AV) fistula with a 30 degrees anastomotic angle and vein-to-artery diameter ratio of 1.6. Flow patterns were obtained by planar illumination of micro-particles suspended in the fluid. Steady and pulsatile flow studies were performed over a range of flow conditions corresponding to those recorded in patients. Quantitative measurements of wall shear stress and turbulence were made using laser Doppler anemometry. The flow structures in pulsatile flow were similar to those seen in steady flow with no significant qualitative changes over the cardiac cycle. This was probably the result of the low pulsatility index of the flow waveform in AV fistulae. Turbulence was the dominant feature in the vein, with relative turbulence intensity > 0.5 within 10 mm of the suture line decreasing to a relatively constant value of about 0.10-0.15 between 40 and 70 mm from the suture line. Peak and mean Reynolds shear stress of 15 and 20 N/m2, respectively, were recorded at the suture line. On the floor of the artery, peak values of temporal mean and oscillating wall shear stress of 9.22 and 29.8 N/m2, respectively. In the vein, both mean and oscillating wall shear stress decreased with distance from the anastomosis.

0 comments Cited 13 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (publisher-id): BPU

Journal ID (nlm-ta): Blood Purif

Journal ID (doi): 10.1159/issn.0253-5068

Title: Blood Purification

Publisher: S. Karger AG

ISSN (Print): 0253-5068

ISSN (Electronic): 1421-9735

Publication date Subscription-year: 2007

Publication date (Print): March 2007

Publication date (Electronic): 05 December 2006

Volume: 25

Issue: 2

Pages: 151-154

Affiliations

^aUnilabs Mittelland, Institut für Pathologie, Bern, Switzerland; ^bFachbereich Gefässchirurgie, Interdisziplinäres Gefässzentrum an der Stadtklinik, Baden-Baden, Germany

Article

Publisher ID: 97751 Other ID: Blood Purif 2007;25:151–154

DOI: 10.1159/000097751

PubMed ID: 17148937

SO-VID: 715c9a83-c45c-4a9b-bab4-8266d04fc7d8

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 11 September 2006

Date accepted : 15 September 2006

Page count

Figures: 2, References: 13, Pages: 4

Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

Submit here before September 30, 2024

Insufficient Arteriovenous Fistulae in Hemodialysis Patients

Read this article at

Abstract

Related collections

Karger: Nephrology

Most cited references 6

Oral anticoagulant treatment: friend or foe in cardiovascular disease?

Oxidative stress and increased expression of growth factors in lesions of failed hemodialysis access.

Flow patterns in the radiocephalic arteriovenous fistula: an in vitro study.

Author and article information

Journal

Affiliations

Article

History

Page count

Categories

Comments

Comment on this article

Similar content 602

Most referenced authors 52