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

Research output: Contribution to journalArticle

20 Citations (Scopus)

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

Fingerprint

Blood Vessels
Dialysis
Pathology
Renal Dialysis
Tunica Intima
Vascular Calcification
Arteriovenous Fistula
Hyperplasia
Fibrosis
Transplants
Research
Therapeutics

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

Cite this

@article{4e133fa53a47471e9c5366b05ea43bff,
title = "New insights into dialysis vascular access: Impact of preexisting arterial and venous pathology on AVF and AVG outcomes",
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.",
keywords = "arteries, arteriovenous fistula, arteriovenous graft, Chronic, Humans, Hyperplasia, intimal hyperplasia, pre-existing pathologies, renal dialysis, Renal Insufficiency, vascular calcification, vascular fibrosis, Veins",
author = "Vazquez-Padron, {Roberto I} and Michael Allon",
year = "2016",
doi = "10.2215/CJN.01860216",
language = "English (US)",
volume = "11",
pages = "1495--1503",
journal = "Clinical journal of the American Society of Nephrology : CJASN",
issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "8",

}

TY - JOUR

T1 - New insights into dialysis vascular access

T2 - Impact of preexisting arterial and venous pathology on AVF and AVG outcomes

AU - Vazquez-Padron, Roberto I

AU - Allon, Michael

PY - 2016

Y1 - 2016

N2 - 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.

AB - 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.

KW - arteries

KW - arteriovenous fistula

KW - arteriovenous graft

KW - Chronic

KW - Humans

KW - Hyperplasia

KW - intimal hyperplasia

KW - pre-existing pathologies

KW - renal dialysis

KW - Renal Insufficiency

KW - vascular calcification

KW - vascular fibrosis

KW - Veins

UR - http://www.scopus.com/inward/record.url?scp=85021745808&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021745808&partnerID=8YFLogxK

U2 - 10.2215/CJN.01860216

DO - 10.2215/CJN.01860216

M3 - Article

C2 - 27401525

AN - SCOPUS:85021745808

VL - 11

SP - 1495

EP - 1503

JO - Clinical journal of the American Society of Nephrology : CJASN

JF - Clinical journal of the American Society of Nephrology : CJASN

SN - 1555-9041

IS - 8

ER -