title: Vascular access in hemodialysis: issues, management, and emerging concepts.
abstract: 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.
authors.affiliation: Division of Nephrology and Hypertension, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH 45267, 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: 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
chemical_list: C000717331:PHB2 protein, human; D000091402:Prohibitins; D011138:Polytetrafluoroethylene