title: Preexisting venous calcification prior to dialysis vascular access surgery.
abstract: Vascular calcification is present in arterial vessels used for dialysis vascular access creation prior to surgical creation. Calcification in the veins used to create a new vascular access has not previously been documented. The objective of this study was to describe the prevalence of venous calcification in samples collected at the time of vascular access creation. Sixty-seven vein samples were studied. A von Kossa stain was performed to quantify calcification. A semi-quantitative scoring system from 0 to 4+ was used to quantify the percentage positive area for calcification as a fraction of total area (0: 0; 1+: 1-10%; 2+: 11-25%; 3+: 26-50%; 4+: >50% positive). Twenty-two of 67 (33%) samples showed evidence of venous calcification. Histologic examination showed varying degrees of calcification within each cell layer. Among the subset of patients with calcification, 4/22 (18%), 19/22 (86%), 22/22 (100%), and 7/22 (32%) had calcification present within the endothelium, intima, media, and adventitia, respectively. The mean semi-quantitative scores of the 22 samples with calcification were 0.18 ± 0.08, 1.2 ± 0.14, 1.6 ± 0.13, and 0.36 ± 0.12 for the endothelium, intima, media, and adventitia, respectively. Our results demonstrate that vascular calcification is present within veins used to create new dialysis vascular access, and located predominately within the neointimal and medial layers.
authors.affiliation: Department of Internal Medicine and Division of Nephrology and Hypertension, University of Cincinnati, Ohio 45267-0585, USA. timmy.lee@uc.edu
authors.forename: Timmy
authors.initials: T
authors.lastname: Lee
authors.forename: Nida
authors.initials: N
authors.lastname: Safdar
authors.forename: Meenakshi J
authors.initials: MJ
authors.lastname: Mistry
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Vibha
authors.initials: V
authors.lastname: Chauhan
authors.forename: Begoña
authors.initials: B
authors.lastname: Campos
authors.forename: Rino
authors.initials: R
authors.lastname: Munda
authors.forename: Virgilius
authors.initials: V
authors.lastname: Cornea
authors.forename: Prabir
authors.initials: P
authors.lastname: Roy-Chaudhury
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D002114:Calcinosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D014680:Veins / Q000473:pathology* / Q000601:surgery*