Vascular access in hemodialysis: issues, management, and emerging concepts.
This article (1) identifies the types of hemodialysis access, (2) summarizes the clinical standard of care for dialysis access grafts and fistulae, (3) describes the pathology and pathogenesis of venous stenosis in dialysis access grafts and fistulae, (4) tabulates avail-able therapies for hemodialysis vascular access dysfunction and speculates on the rea-sons for the lack of effective therapies, and (5) discusses the development and application of novel therapeutic interventions for this difficult clinical problem. The possibility that dialysis access grafts and fistulae could be the ideal clinical model for testing novel local therapies to block neointimal hyperplasia is discussed.
Roy-Chaudhury
Prabir
P
Division of Nephrology and Hypertension, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH 45267, USA. roychap@ucmail.uc.edu
Kelly
Burnett S
BS
Melhem
Murad
M
Zhang
Jianhua
J
Li
Jinsong
J
Desai
Pankaj
P
Munda
Rino
R
Heffelfinger
Sue C
SC
D001163:Arteriovenous Anastomosis; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects* / Q000379:methods; D001807:Blood Vessel Prosthesis; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D011138:Polytetrafluoroethylene; D000091402:Prohibitins; D006435:Renal Dialysis
C000717331:PHB2 protein, human; D000091402:Prohibitins; D011138:Polytetrafluoroethylene