Nonmaturation of arm arteriovenous fistulas for hemodialysis access: A systematic review of risk factors and results of early treatment

Voormolen, Eduard; Jahrome, A. Khodadade; Bartels, Lambertus W.; Moll, Frans L.; Mali, W. P. T. M.; Blankestijn, Peter J.

doi:10.1016/j.jvs.2008.11.059

Cited by 60 publications

(40 citation statements)

References 43 publications

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“…; Voormolen et al. ; Smith et al. ), the impact of a potentially optimal diameter of the anastomosis is still controversial due to the difficulties of surgical standardization, postoperative surveillance, as well as variations in human anatomy and physiology.…”

Section: Discussionmentioning

confidence: 99%

Disturbed shear stress reduces Klf2 expression in arterial-venous fistulae in vivo

et al. 2015

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Laminar shear stress (SS) induces an antiproliferative and anti-inflammatory endothelial phenotype and increases Klf2 expression. We altered the diameter of an arteriovenous fistula (AVF) in the mouse model to determine whether increased fistula diameter produces disturbed SS in vivo and if acutely increased disturbed SS results in decreased Klf2 expression. The mouse aortocaval fistula model was performed with 22, 25, or 28 gauge needles to puncture the aorta and the inferior vena cava. Duplex ultrasound was used to examine the AVF and its arterial inflow and venous outflow, and SS was calculated. Arterial samples were examined with western blot, immunohistochemistry, and immunofluorescence analysis for proteins and qPCR for RNA. Mice with larger diameter fistulae had diminished survival but increased AVF patency. Increased SS magnitudes and range of frequencies were directly proportional to the needle diameter in the arterial limb proximal to the fistula but not in the venous limb distal to the fistula, with 22-gauge needles producing the most disturbed SS in vivo. Klf2 mRNA and protein expression was diminished in the artery proximal to the fistula in proportion to increasing SS. Increased fistula diameter produces increased SS magnitude and frequency, consistent with disturbed SS in vivo. Disturbed SS is associated with decreased mRNA and protein expression of Klf2. Disturbed SS and reduced Klf2 expression near the fistula are potential therapeutic targets to improve AVF maturation.

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Section: Discussionmentioning

confidence: 99%

Disturbed shear stress reduces Klf2 expression in arterial-venous fistulae in vivo

et al. 2015

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“…However, other studies have also shown no association between diabetes and time to maturation (33), risk of nonmaturation (34,35), or patency (36). Even in a well validated prediction model (37), no association between diabetes and risk of nonmaturation was found (27). Given the disparate outcomes, it is likely that the relationship between diabetes and AVF outcomes is complex and may be related to a variety of diabetes-associated pathologic factors, such as the presence of arterial calcification, atherosclerosis, and vessel damage.…”

Section: Comorbiditiesmentioning

confidence: 95%

New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?

Woo

2016

CJASN

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Optimal vascular access planning begins when the patient is in the predialysis stages of CKD. The choice of optimal vascular access for an individual patient and determining timing of access creation are dependent on a multitude of factors that can vary widely with each patient, including demographics, comorbidities, anatomy, and personal preferences. It is important to consider every patient's ESRD life plan (hence, their overall dialysis access life plan for every vascular access creation or placement). Optimal access type and timing of access creation are also influenced by factors external to the patient, such as surgeon experience and processes of care. In this review, we will discuss the key determinants in optimal access type and timing of access creation for upper extremity arteriovenous fistulas and grafts.

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“…It is known that some patients require multiple procedures for the successful establishment of vascular access for HD [11,24]. The present study found that 37% of patients underwent at least one additional vascular access procedure prior to commencement of HD.…”

Section: Discussionmentioning

confidence: 57%

Clinical Outcomes after Arteriovenous Fistula Creation in Chronic Kidney Disease

et al. 2014

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Background: Optimal timing of arteriovenous fistula (AVF) surgery in chronic kidney disease (CKD) is uncertain. Methods: A single-centre retrospective study of pre-dialysis CKD patients having first AVF surgery. Results: The median estimated glomerular filtration rate (eGFR) at the time of AVF surgery in 100 patients was 15 ml/min/1.73 m², with patients classified as having an early AVF if eGFR was >15 ml/min/1.73 m² (n = 46) or a late AVF if eGFR was ≤15 ml/min/1.73 m² (n = 54). In the eGFR ≤15 group, 81% of patients started haemodialysis (HD), compared with 63% of the eGFR >15 patients (p = 0.04). The median time to starting HD was 30.3 months in the eGFR >15 group compared to 10.7 months for the eGFR ≤15 group (log rank p = 0.018). There were no differences in the requirements for a dialysis catheter (eGFR >15 24% vs. eGFR ≤15 11%, p = 0.20) or additional access procedures between the two groups. Conclusions: AVF surgery with an eGFR >15 ml/min/1.73 m² was associated with a higher risk of AVF non-use and a more prolonged time to the need for HD.

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Nonmaturation of arm arteriovenous fistulas for hemodialysis access: A systematic review of risk factors and results of early treatment

Cited by 60 publications

References 43 publications

Disturbed shear stress reduces Klf2 expression in arterial-venous fistulae in vivo

Disturbed shear stress reduces Klf2 expression in arterial-venous fistulae in vivo

New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?

Clinical Outcomes after Arteriovenous Fistula Creation in Chronic Kidney Disease

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