New insights into dialysis vascular access: Impact of preexisting arterial and venous pathology on AVF and AVG outcomes

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Despite significant improvements in preoperative patient evaluation and surgical planning, vascular access failure in patients on hemodialysis remains a frequent and often unforeseeable complication.Our inability to prevent this complication is, in part, because of an incomplete understanding of how preexisting venous and arterial conditions influence the function of newly created arteriovenous fistulas and grafts. This article reviews the relationship between three preexisting vascular pathologies associated with CKD (intimal hyperplasia, vascular calcification, and medial fibrosis) and hemodialysis access outcomes. The published literature indicates that the pathogenesis of vascular access failure is multifactorial and not determined by any of these pathologies individually. Keeping this observation in mind should help focus our research on the true causes responsible for vascular access failure and the much needed therapies to prevent it.

Original languageEnglish (US)
Pages (from-to)1495-1503
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume11
Issue number8
DOIs
StatePublished - 2016

Keywords

  • arteries
  • arteriovenous fistula
  • arteriovenous graft
  • Chronic
  • Humans
  • Hyperplasia
  • intimal hyperplasia
  • pre-existing pathologies
  • renal dialysis
  • Renal Insufficiency
  • vascular calcification
  • vascular fibrosis
  • Veins

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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