title: Relationship of late arteriovenous fistula stenosis with soluble E-selectin and soluble EPCR in chronic hemodialysis patients with arteriovenous fistula.
abstract: OBJECTIVE
  Vascular access dysfunction caused by stenosis is a major complication for hemodialysis (HD) patients. However, physiopathology of late arteriovenous fistula (AVF) stenosis is still under investigation. The aim of the present study was to evaluate the association between plasma soluble EPCR (sEPCR) with serum soluble E-selectin (sE-selectin) concentration and late AVF stenosis in HD patients.
  
  
  METHODS
  Plasma sEPCR and serum sE-selectin concentrations were measured in 94 HD patients. Using these data, we studied the association of sEPCR and sE-selectin with the presence and degree of AVF stenosis using ultrasonography and fistulogram.
  
  
  RESULTS
  Fifty-one patients have AVF stenosis, and the others (n = 43) have patent AVF. The degree of AVF stenosis was correlated with serum sE-selectin levels (r = 0.351, p = 0.01), but not sEPCR (r = 0.075, p = 0.702). The median level of sE-selectin was statistically higher in the group of AVF stenosis than in the group of patent AVF [463.2 pg/ml (275.4-671.4) vs. 162.5 pg/ml (96.7-285.3), p = 0.001]. Increased sE-selectin levels [OR (OR) = 6.356, p = 0.015] and high levels of LDL (OR = 4.321, p = 0.044) were independent predictors of late AVF stenosis in the multivariate model.
  
  
  CONCLUSIONS
  sE-selectin and the LDL were the most important predictors of late AVF stenosis. In addition, sE-selectin correlated with the degree of AVF stenosis. We suggested that atherosclerosis might be contributing factor for development of late AVF stenosis.
authors.affiliation: Section of Nephrology, Department of Internal Medicine, School of Medicine, Turgut Ozal University, Alparslan Türkes Cad. No: 57, 06510, Ankara, Turkey.
authors.forename: Mukadder Ayse
authors.initials: MA
authors.lastname: Bilgic
authors.forename: Hakki
authors.initials: H
authors.lastname: Yilmaz
authors.forename: Alper
authors.initials: A
authors.lastname: Bozkurt
authors.forename: Huseyin Tugrul
authors.initials: HT
authors.lastname: Celik
authors.forename: Ismail Celal
authors.initials: IC
authors.lastname: Bilgic
authors.forename: Ozgul Malcok
authors.initials: OM
authors.lastname: Gurel
authors.forename: Ismail
authors.initials: I
authors.lastname: Kirbas
authors.forename: Nuket
authors.initials: N
authors.lastname: Bavbek
authors.forename: Ali
authors.initials: A
authors.lastname: Akcay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D015703:Antigens, CD / Q000097:blood*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000473:pathology*; D008078:Cholesterol, LDL / Q000097:blood; D003251:Constriction, Pathologic; D019040:E-Selectin / Q000097:blood*; D000074283:Endothelial Protein C Receptor; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011956:Receptors, Cell Surface / Q000097:blood*; D006435:Renal Dialysis; D018615:Ultrasonography, Doppler, Color; D062666:Vascular Access Devices / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D008078:Cholesterol, LDL; D019040:E-Selectin; D000074283:Endothelial Protein C Receptor; C478370:PROCR protein, human; D011956:Receptors, Cell Surface