title: Novel therapies for hemodialysis vascular access dysfunction: fact or fiction!
abstract: Hemodialysis vascular access dysfunction is a major cause of morbidity in the hemodialysis population and contributes significantly to the overall cost of end-stage renal disease programs. At a histological level, most hemodialysis vascular access dysfunction (in both native arteriovenous fistulae and PTFE dialysis access grafts) is due to venous stenosis and thrombosis, secondary to venous neointimal hyperplasia. However, despite a wealth of experimental and clinical data on the use of novel therapeutic interventions that target neointimal hyperplasia in the setting of coronary artery disease, there are unfortunately no effective therapeutic interventions for hemodialysis vascular access dysfunction at the present time. This is particularly unfortunate, since neointimal hyperplasia in the setting of hemodialysis vascular access fistulae and grafts could be the ideal clinical model to test novel therapeutic interventions for neointimal hyperplasia.
authors.affiliation: University of Cincinnati Medical Center, Cincinnati, Ohio, USA. roychap@ucmail.uc.edu
authors.forename: Prabir
authors.initials: P
authors.lastname: Roy-Chaudhury
authors.forename: Burnett S
authors.initials: BS
authors.lastname: Kelly
authors.forename: Murad
authors.initials: M
authors.lastname: Melhem
authors.forename: Jianhua
authors.initials: J
authors.lastname: Zhang
authors.forename: Jinsong
authors.initials: J
authors.lastname: Li
authors.forename: Pankaj
authors.initials: P
authors.lastname: Desai
authors.forename: Rino
authors.initials: R
authors.lastname: Munda
authors.forename: Sue C
authors.initials: SC
authors.lastname: Heffelfinger
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D006083:Graft Occlusion, Vascular / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006965:Hyperplasia / Q000473:pathology / Q000628:therapy; D011138:Polytetrafluoroethylene / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation
chemical_list: D011138:Polytetrafluoroethylene