Does vascular elasticity affect arteriovenous fistula maturation?

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The vasculopathy of ESRD affects both arteries and veins. The arteries develop arteriosclerosis, which is largely a disease of the media characterized by increased collagen content, calcification, and both hypertrophy and hyperplasia of vascular smooth muscle cells. Veins may exhibit increased width of the intimal and medial layers, and may develop neointimal hyperplasia and calcification. Successful fistula maturation depends upon dilatation and remodeling of the artery and vein, but the stiff and thickened vessels of ESRD patients may respond poorly to signals that promote these adaptations. There is intense interest in accurately predicting fistula maturation outcome and preventing maturation failure. However, definitive criteria for preoperative testing of vessel elasticity have not yet been established. Tests that are adopted for widespread clinical use will need to be easy to apply - a standard that many of these tests may not meet. Finally, effective treatments are needed that prevent or reduce the stiffness of vessels. In conclusion, although there are many promising developments in this emerging field, effective methods of predicting fistula maturation outcome and preventing maturation failure remain to be established.

Original languageEnglish (US)
Pages (from-to)26-32
Number of pages7
JournalOpen Urology and Nephrology Journal
Volume7
Issue numberSPEC.ISS.1
DOIs
StatePublished - Jan 1 2014

Fingerprint

Arteriovenous Fistula
Elasticity
Fistula
Blood Vessels
Veins
Arteries
Chronic Kidney Failure
Hyperplasia
Tunica Intima
Arteriosclerosis
Vascular Smooth Muscle
Hypertrophy
Smooth Muscle Myocytes
Dilatation
Collagen
Therapeutics

Keywords

  • Arterial stiffness
  • Arteriosclerosis
  • Arteriovenous fistula
  • Calcification
  • Dialysis access
  • Hemodialysis
  • Vascular access
  • Venous distensibility

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

Does vascular elasticity affect arteriovenous fistula maturation? / Paulson, William D.

In: Open Urology and Nephrology Journal, Vol. 7, No. SPEC.ISS.1, 01.01.2014, p. 26-32.

Research output: Contribution to journalArticle

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